Daily Papers

The goal of automated summarization techniques (Paice, 1990; Kupiec et al, 1995) is to condense text by focusing on the most critical information. Generative large language models (LLMs) have shown to be robust summarizers, yet traditional metrics struggle to capture resulting performance (Goyal et al, 2022) in more powerful LLMs. In safety-critical domains such as medicine, more rigorous evaluation is required, especially given the potential for LLMs to omit important information in the resulting summary. We propose MED-OMIT, a new omission benchmark for medical summarization. Given a doctor-patient conversation and a generated summary, MED-OMIT categorizes the chat into a set of facts and identifies which are omitted from the summary. We further propose to determine fact importance by simulating the impact of each fact on a downstream clinical task: differential diagnosis (DDx) generation. MED-OMIT leverages LLM prompt-based approaches which categorize the importance of facts and cluster them as supporting or negating evidence to the diagnosis. We evaluate MED-OMIT on a publicly-released dataset of patient-doctor conversations and find that MED-OMIT captures omissions better than alternative metrics.

An accurate differential diagnosis (DDx) is a cornerstone of medical care, often reached through an iterative process of interpretation that combines clinical history, physical examination, investigations and procedures. Interactive interfaces powered by Large Language Models (LLMs) present new opportunities to both assist and automate aspects of this process. In this study, we introduce an LLM optimized for diagnostic reasoning, and evaluate its ability to generate a DDx alone or as an aid to clinicians. 20 clinicians evaluated 302 challenging, real-world medical cases sourced from the New England Journal of Medicine (NEJM) case reports. Each case report was read by two clinicians, who were randomized to one of two assistive conditions: either assistance from search engines and standard medical resources, or LLM assistance in addition to these tools. All clinicians provided a baseline, unassisted DDx prior to using the respective assistive tools. Our LLM for DDx exhibited standalone performance that exceeded that of unassisted clinicians (top-10 accuracy 59.1% vs 33.6%, [p = 0.04]). Comparing the two assisted study arms, the DDx quality score was higher for clinicians assisted by our LLM (top-10 accuracy 51.7%) compared to clinicians without its assistance (36.1%) (McNemar's Test: 45.7, p < 0.01) and clinicians with search (44.4%) (4.75, p = 0.03). Further, clinicians assisted by our LLM arrived at more comprehensive differential lists than those without its assistance. Our study suggests that our LLM for DDx has potential to improve clinicians' diagnostic reasoning and accuracy in challenging cases, meriting further real-world evaluation for its ability to empower physicians and widen patients' access to specialist-level expertise.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Differential diagnosis is crucial for medicine as it helps healthcare providers systematically distinguish between conditions that share similar symptoms. This study assesses the impact of lab test results on differential diagnoses (DDx) made by large language models (LLMs). Clinical vignettes from 50 case reports from PubMed Central were created incorporating patient demographics, symptoms, and lab results. Five LLMs GPT-4, GPT-3.5, Llama-2-70b, Claude-2, and Mixtral-8x7B were tested to generate Top 10, Top 5, and Top 1 DDx with and without lab data. A comprehensive evaluation involving GPT-4, a knowledge graph, and clinicians was conducted. GPT-4 performed best, achieving 55% accuracy for Top 1 diagnoses and 60% for Top 10 with lab data, with lenient accuracy up to 80%. Lab results significantly improved accuracy, with GPT-4 and Mixtral excelling, though exact match rates were low. Lab tests, including liver function, metabolic/toxicology panels, and serology/immune tests, were generally interpreted correctly by LLMs for differential diagnosis.

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

Denoising diffusion probabilistic models (DDPMs) have been proven capable of synthesizing high-quality images with remarkable diversity when trained on large amounts of data. Typical diffusion models and modern large-scale conditional generative models like text-to-image generative models are vulnerable to overfitting when fine-tuned on extremely limited data. Existing works have explored subject-driven generation using a reference set containing a few images. However, few prior works explore DDPM-based domain-driven generation, which aims to learn the common features of target domains while maintaining diversity. This paper proposes a novel DomainStudio approach to adapt DDPMs pre-trained on large-scale source datasets to target domains using limited data. It is designed to keep the diversity of subjects provided by source domains and get high-quality and diverse adapted samples in target domains. We propose to keep the relative distances between adapted samples to achieve considerable generation diversity. In addition, we further enhance the learning of high-frequency details for better generation quality. Our approach is compatible with both unconditional and conditional diffusion models. This work makes the first attempt to realize unconditional few-shot image generation with diffusion models, achieving better quality and greater diversity than current state-of-the-art GAN-based approaches. Moreover, this work also significantly relieves overfitting for conditional generation and realizes high-quality domain-driven generation, further expanding the applicable scenarios of modern large-scale text-to-image models.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Discrete diffusion has achieved state-of-the-art performance, outperforming or approaching autoregressive models on standard benchmarks. In this work, we introduce Discrete Diffusion with Planned Denoising (DDPD), a novel framework that separates the generation process into two models: a planner and a denoiser. At inference time, the planner selects which positions to denoise next by identifying the most corrupted positions in need of denoising, including both initially corrupted and those requiring additional refinement. This plan-and-denoise approach enables more efficient reconstruction during generation by iteratively identifying and denoising corruptions in the optimal order. DDPD outperforms traditional denoiser-only mask diffusion methods, achieving superior results on language modeling benchmarks such as text8, OpenWebText, and token-based generation on ImageNet 256 times 256. Notably, in language modeling, DDPD significantly reduces the performance gap between diffusion-based and autoregressive methods in terms of generative perplexity. Code is available at https://github.com/liusulin/DDPD.

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.

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

Despite the ever-increasing interest in applying deep learning (DL) models to medical imaging, the typical scarcity and imbalance of medical datasets can severely impact the performance of DL models. The generation of synthetic data that might be freely shared without compromising patient privacy is a well-known technique for addressing these difficulties. Inpainting algorithms are a subset of DL generative models that can alter one or more regions of an input image while matching its surrounding context and, in certain cases, non-imaging input conditions. Although the majority of inpainting techniques for medical imaging data use generative adversarial networks (GANs), the performance of these algorithms is frequently suboptimal due to their limited output variety, a problem that is already well-known for GANs. Denoising diffusion probabilistic models (DDPMs) are a recently introduced family of generative networks that can generate results of comparable quality to GANs, but with diverse outputs. In this paper, we describe a DDPM to execute multiple inpainting tasks on 2D axial slices of brain MRI with various sequences, and present proof-of-concept examples of its performance in a variety of evaluation scenarios. Our model and a public online interface to try our tool are available at: https://github.com/Mayo-Radiology-Informatics-Lab/MBTI

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Denoising Diffusion Probabilistic Models (DDPMs) can generate high-quality samples such as image and audio samples. However, DDPMs require hundreds to thousands of iterations to produce final samples. Several prior works have successfully accelerated DDPMs through adjusting the variance schedule (e.g., Improved Denoising Diffusion Probabilistic Models) or the denoising equation (e.g., Denoising Diffusion Implicit Models (DDIMs)). However, these acceleration methods cannot maintain the quality of samples and even introduce new noise at a high speedup rate, which limit their practicability. To accelerate the inference process while keeping the sample quality, we provide a fresh perspective that DDPMs should be treated as solving differential equations on manifolds. Under such a perspective, we propose pseudo numerical methods for diffusion models (PNDMs). Specifically, we figure out how to solve differential equations on manifolds and show that DDIMs are simple cases of pseudo numerical methods. We change several classical numerical methods to corresponding pseudo numerical methods and find that the pseudo linear multi-step method is the best in most situations. According to our experiments, by directly using pre-trained models on Cifar10, CelebA and LSUN, PNDMs can generate higher quality synthetic images with only 50 steps compared with 1000-step DDIMs (20x speedup), significantly outperform DDIMs with 250 steps (by around 0.4 in FID) and have good generalization on different variance schedules. Our implementation is available at https://github.com/luping-liu/PNDM.

Examining Drug-Drug Interactions (DDIs) is a pivotal element in the process of drug development. DDIs occur when one drug's properties are affected by the inclusion of other drugs. Detecting favorable DDIs has the potential to pave the way for creating and advancing innovative medications applicable in practical settings. However, existing DDI prediction models continue to face challenges related to generalization in extreme cases, robust feature extraction, and real-life application possibilities. We aim to address these challenges by leveraging the effectiveness of context-aware deep graph learning by introducing a novel framework named CADGL. Based on a customized variational graph autoencoder (VGAE), we capture critical structural and physio-chemical information using two context preprocessors for feature extraction from two different perspectives: local neighborhood and molecular context, in a heterogeneous graphical structure. Our customized VGAE consists of a graph encoder, a latent information encoder, and an MLP decoder. CADGL surpasses other state-of-the-art DDI prediction models, excelling in predicting clinically valuable novel DDIs, supported by rigorous case studies.

Generalist Large Language Models (LLMs), such as GPT-4, have shown considerable promise in various domains, including medical diagnosis. Rare diseases, affecting approximately 300 million people worldwide, often have unsatisfactory clinical diagnosis rates primarily due to a lack of experienced physicians and the complexity of differentiating among many rare diseases. In this context, recent news such as "ChatGPT correctly diagnosed a 4-year-old's rare disease after 17 doctors failed" underscore LLMs' potential, yet underexplored, role in clinically diagnosing rare diseases. To bridge this research gap, we introduce RareBench, a pioneering benchmark designed to systematically evaluate the capabilities of LLMs on 4 critical dimensions within the realm of rare diseases. Meanwhile, we have compiled the largest open-source dataset on rare disease patients, establishing a benchmark for future studies in this domain. To facilitate differential diagnosis of rare diseases, we develop a dynamic few-shot prompt methodology, leveraging a comprehensive rare disease knowledge graph synthesized from multiple knowledge bases, significantly enhancing LLMs' diagnostic performance. Moreover, we present an exhaustive comparative study of GPT-4's diagnostic capabilities against those of specialist physicians. Our experimental findings underscore the promising potential of integrating LLMs into the clinical diagnostic process for rare diseases. This paves the way for exciting possibilities in future advancements in this field.

The rapid advancement of Artificial Intelligence (AI) in biomedical imaging and radiotherapy is hindered by the limited availability of large imaging data repositories. With recent research and improvements in denoising diffusion probabilistic models (DDPM), high quality synthetic medical scans are now possible. Despite this, there is currently no way of generating multiple related images, such as a corresponding ground truth which can be used to train models, so synthetic scans are often manually annotated before use. This research introduces a novel architecture that is able to generate multiple, related PET-CT-tumour mask pairs using paired networks and conditional encoders. Our approach includes innovative, time step-controlled mechanisms and a `noise-seeding' strategy to improve DDPM sampling consistency. While our model requires a modified perceptual loss function to ensure accurate feature alignment we show generation of clearly aligned synthetic images and improvement in segmentation accuracy with generated images.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Digitally reconstructed radiographs (DRRs) are simulated 2D X-ray images generated from 3D CT volumes, widely used in preoperative settings but limited in intraoperative applications due to computational bottlenecks, especially for accurate but heavy physics-based Monte Carlo methods. While analytical DRR renderers offer greater efficiency, they overlook anisotropic X-ray image formation phenomena, such as Compton scattering. We present a novel approach that marries realistic physics-inspired X-ray simulation with efficient, differentiable DRR generation using 3D Gaussian splatting (3DGS). Our direction-disentangled 3DGS (DDGS) method separates the radiosity contribution into isotropic and direction-dependent components, approximating complex anisotropic interactions without intricate runtime simulations. Additionally, we adapt the 3DGS initialization to account for tomography data properties, enhancing accuracy and efficiency. Our method outperforms state-of-the-art techniques in image accuracy. Furthermore, our DDGS shows promise for intraoperative applications and inverse problems such as pose registration, delivering superior registration accuracy and runtime performance compared to analytical DRR methods.

Diffusion probabilistic models (DPMs) have become the state-of-the-art in high-quality image generation. However, DPMs have an arbitrary noisy latent space with no interpretable or controllable semantics. Although there has been significant research effort to improve image sample quality, there is little work on representation-controlled generation using diffusion models. Specifically, causal modeling and controllable counterfactual generation using DPMs is an underexplored area. In this work, we propose CausalDiffAE, a diffusion-based causal representation learning framework to enable counterfactual generation according to a specified causal model. Our key idea is to use an encoder to extract high-level semantically meaningful causal variables from high-dimensional data and model stochastic variation using reverse diffusion. We propose a causal encoding mechanism that maps high-dimensional data to causally related latent factors and parameterize the causal mechanisms among latent factors using neural networks. To enforce the disentanglement of causal variables, we formulate a variational objective and leverage auxiliary label information in a prior to regularize the latent space. We propose a DDIM-based counterfactual generation procedure subject to do-interventions. Finally, to address the limited label supervision scenario, we also study the application of CausalDiffAE when a part of the training data is unlabeled, which also enables granular control over the strength of interventions in generating counterfactuals during inference. We empirically show that CausalDiffAE learns a disentangled latent space and is capable of generating high-quality counterfactual images.

While 2D diffusion models generate realistic, high-detail images, 3D shape generation methods like Score Distillation Sampling (SDS) built on these 2D diffusion models produce cartoon-like, over-smoothed shapes. To help explain this discrepancy, we show that the image guidance used in Score Distillation can be understood as the velocity field of a 2D denoising generative process, up to the choice of a noise term. In particular, after a change of variables, SDS resembles a high-variance version of Denoising Diffusion Implicit Models (DDIM) with a differently-sampled noise term: SDS introduces noise i.i.d. randomly at each step, while DDIM infers it from the previous noise predictions. This excessive variance can lead to over-smoothing and unrealistic outputs. We show that a better noise approximation can be recovered by inverting DDIM in each SDS update step. This modification makes SDS's generative process for 2D images almost identical to DDIM. In 3D, it removes over-smoothing, preserves higher-frequency detail, and brings the generation quality closer to that of 2D samplers. Experimentally, our method achieves better or similar 3D generation quality compared to other state-of-the-art Score Distillation methods, all without training additional neural networks or multi-view supervision, and providing useful insights into relationship between 2D and 3D asset generation with diffusion models.

Denoising diffusion bridge models (DDBMs) are a powerful variant of diffusion models for interpolating between two arbitrary paired distributions given as endpoints. Despite their promising performance in tasks like image translation, DDBMs require a computationally intensive sampling process that involves the simulation of a (stochastic) differential equation through hundreds of network evaluations. In this work, we take the first step in fast sampling of DDBMs without extra training, motivated by the well-established recipes in diffusion models. We generalize DDBMs via a class of non-Markovian diffusion bridges defined on the discretized timesteps concerning sampling, which share the same marginal distributions and training objectives, give rise to generative processes ranging from stochastic to deterministic, and result in diffusion bridge implicit models (DBIMs). DBIMs are not only up to 25times faster than the vanilla sampler of DDBMs but also induce a novel, simple, and insightful form of ordinary differential equation (ODE) which inspires high-order numerical solvers. Moreover, DBIMs maintain the generation diversity in a distinguished way, by using a booting noise in the initial sampling step, which enables faithful encoding, reconstruction, and semantic interpolation in image translation tasks. Code is available at https://github.com/thu-ml/DiffusionBridge.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

In medical imaging, the diffusion models have shown great potential in synthetic image generation tasks. However, these models often struggle with the interpretable connections between the generated and existing images and could create illusions. To address these challenges, our research proposes a novel diffusion-based generative model based on deformation diffusion and recovery. This model, named Deformation-Recovery Diffusion Model (DRDM), diverges from traditional score/intensity and latent feature-based approaches, emphasizing morphological changes through deformation fields rather than direct image synthesis. This is achieved by introducing a topological-preserving deformation field generation method, which randomly samples and integrates a set of multi-scale Deformation Vector Fields (DVF). DRDM is trained to learn to recover unreasonable deformation components, thereby restoring each randomly deformed image to a realistic distribution. These innovations facilitate the generation of diverse and anatomically plausible deformations, enhancing data augmentation and synthesis for further analysis in downstream tasks, such as few-shot learning and image registration. Experimental results in cardiac MRI and pulmonary CT show DRDM is capable of creating diverse, large (over 10\% image size deformation scale), and high-quality (negative rate of the Jacobian matrix's determinant is lower than 1\%) deformation fields. The further experimental results in downstream tasks, 2D image segmentation and 3D image registration, indicate significant improvements resulting from DRDM, showcasing the potential of our model to advance image manipulation and synthesis in medical imaging and beyond. Project page: https://jianqingzheng.github.io/def_diff_rec/

Autoregressive (AR) models have achieved state-of-the-art performance in text and image generation but suffer from slow generation due to the token-by-token process. We ask an ambitious question: can a pre-trained AR model be adapted to generate outputs in just one or two steps? If successful, this would significantly advance the development and deployment of AR models. We notice that existing works that try to speed up AR generation by generating multiple tokens at once fundamentally cannot capture the output distribution due to the conditional dependencies between tokens, limiting their effectiveness for few-step generation. To address this, we propose Distilled Decoding (DD), which uses flow matching to create a deterministic mapping from Gaussian distribution to the output distribution of the pre-trained AR model. We then train a network to distill this mapping, enabling few-step generation. DD doesn't need the training data of the original AR model, making it more practical.We evaluate DD on state-of-the-art image AR models and present promising results on ImageNet-256. For VAR, which requires 10-step generation, DD enables one-step generation (6.3times speed-up), with an acceptable increase in FID from 4.19 to 9.96. For LlamaGen, DD reduces generation from 256 steps to 1, achieving an 217.8times speed-up with a comparable FID increase from 4.11 to 11.35. In both cases, baseline methods completely fail with FID>100. DD also excels on text-to-image generation, reducing the generation from 256 steps to 2 for LlamaGen with minimal FID increase from 25.70 to 28.95. As the first work to demonstrate the possibility of one-step generation for image AR models, DD challenges the prevailing notion that AR models are inherently slow, and opens up new opportunities for efficient AR generation. The project website is at https://imagination-research.github.io/distilled-decoding.

The rise of large language models (LLMs) has driven significant progress in medical applications, including traditional Chinese medicine (TCM). However, current medical LLMs struggle with TCM diagnosis and syndrome differentiation due to substantial differences between TCM and modern medical theory, and the scarcity of specialized, high-quality corpora. This paper addresses these challenges by proposing BianCang, a TCM-specific LLM, using a two-stage training process that first injects domain-specific knowledge and then aligns it through targeted stimulation. To enhance diagnostic and differentiation capabilities, we constructed pre-training corpora, instruction-aligned datasets based on real hospital records, and the ChP-TCM dataset derived from the Pharmacopoeia of the People's Republic of China. We compiled extensive TCM and medical corpora for continuous pre-training and supervised fine-tuning, building a comprehensive dataset to refine the model's understanding of TCM. Evaluations across 11 test sets involving 29 models and 4 tasks demonstrate the effectiveness of BianCang, offering valuable insights for future research. Code, datasets, and models are available at https://github.com/QLU-NLP/BianCang.

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

Taming the generation outcome of state of the art Diffusion and Flow-Matching (FM) models without having to re-train a task-specific model unlocks a powerful tool for solving inverse problems, conditional generation, and controlled generation in general. In this work we introduce D-Flow, a simple framework for controlling the generation process by differentiating through the flow, optimizing for the source (noise) point. We motivate this framework by our key observation stating that for Diffusion/FM models trained with Gaussian probability paths, differentiating through the generation process projects gradient on the data manifold, implicitly injecting the prior into the optimization process. We validate our framework on linear and non-linear controlled generation problems including: image and audio inverse problems and conditional molecule generation reaching state of the art performance across all.

Designing biological sequences is an important challenge that requires satisfying complex constraints and thus is a natural problem to address with deep generative modeling. Diffusion generative models have achieved considerable success in many applications. Score-based generative stochastic differential equations (SDE) model is a continuous-time diffusion model framework that enjoys many benefits, but the originally proposed SDEs are not naturally designed for modeling discrete data. To develop generative SDE models for discrete data such as biological sequences, here we introduce a diffusion process defined in the probability simplex space with stationary distribution being the Dirichlet distribution. This makes diffusion in continuous space natural for modeling discrete data. We refer to this approach as Dirchlet diffusion score model. We demonstrate that this technique can generate samples that satisfy hard constraints using a Sudoku generation task. This generative model can also solve Sudoku, including hard puzzles, without additional training. Finally, we applied this approach to develop the first human promoter DNA sequence design model and showed that designed sequences share similar properties with natural promoter sequences.

Skin conditions affect an estimated 1.9 billion people worldwide. A shortage of dermatologists causes long wait times and leads patients to seek dermatologic care from general practitioners. However, the diagnostic accuracy of general practitioners has been reported to be only 0.24-0.70 (compared to 0.77-0.96 for dermatologists), resulting in referral errors, delays in care, and errors in diagnosis and treatment. In this paper, we developed a deep learning system (DLS) to provide a differential diagnosis of skin conditions for clinical cases (skin photographs and associated medical histories). The DLS distinguishes between 26 skin conditions that represent roughly 80% of the volume of skin conditions seen in primary care. The DLS was developed and validated using de-identified cases from a teledermatology practice serving 17 clinical sites via a temporal split: the first 14,021 cases for development and the last 3,756 cases for validation. On the validation set, where a panel of three board-certified dermatologists defined the reference standard for every case, the DLS achieved 0.71 and 0.93 top-1 and top-3 accuracies respectively. For a random subset of the validation set (n=963 cases), 18 clinicians reviewed the cases for comparison. On this subset, the DLS achieved a 0.67 top-1 accuracy, non-inferior to board-certified dermatologists (0.63, p<0.001), and higher than primary care physicians (PCPs, 0.45) and nurse practitioners (NPs, 0.41). The top-3 accuracy showed a similar trend: 0.90 DLS, 0.75 dermatologists, 0.60 PCPs, and 0.55 NPs. These results highlight the potential of the DLS to augment general practitioners to accurately diagnose skin conditions by suggesting differential diagnoses that may not have been considered. Future work will be needed to prospectively assess the clinical impact of using this tool in actual clinical workflows.

Most generative models of audio directly generate samples in one of two domains: time or frequency. While sufficient to express any signal, these representations are inefficient, as they do not utilize existing knowledge of how sound is generated and perceived. A third approach (vocoders/synthesizers) successfully incorporates strong domain knowledge of signal processing and perception, but has been less actively researched due to limited expressivity and difficulty integrating with modern auto-differentiation-based machine learning methods. In this paper, we introduce the Differentiable Digital Signal Processing (DDSP) library, which enables direct integration of classic signal processing elements with deep learning methods. Focusing on audio synthesis, we achieve high-fidelity generation without the need for large autoregressive models or adversarial losses, demonstrating that DDSP enables utilizing strong inductive biases without losing the expressive power of neural networks. Further, we show that combining interpretable modules permits manipulation of each separate model component, with applications such as independent control of pitch and loudness, realistic extrapolation to pitches not seen during training, blind dereverberation of room acoustics, transfer of extracted room acoustics to new environments, and transformation of timbre between disparate sources. In short, DDSP enables an interpretable and modular approach to generative modeling, without sacrificing the benefits of deep learning. The library is publicly available at https://github.com/magenta/ddsp and we welcome further contributions from the community and domain experts.

Denoising diffusion models (DDMs) have led to staggering performance leaps in image generation, editing and restoration. However, existing DDMs use very large datasets for training. Here, we introduce a framework for training a DDM on a single image. Our method, which we coin SinDDM, learns the internal statistics of the training image by using a multi-scale diffusion process. To drive the reverse diffusion process, we use a fully-convolutional light-weight denoiser, which is conditioned on both the noise level and the scale. This architecture allows generating samples of arbitrary dimensions, in a coarse-to-fine manner. As we illustrate, SinDDM generates diverse high-quality samples, and is applicable in a wide array of tasks, including style transfer and harmonization. Furthermore, it can be easily guided by external supervision. Particularly, we demonstrate text-guided generation from a single image using a pre-trained CLIP model.

The in-vivo identification of the kidney stone types during an ureteroscopy would be a major medical advance in urology, as it could reduce the time of the tedious renal calculi extraction process, while diminishing infection risks. Furthermore, such an automated procedure would make possible to prescribe anti-recurrence treatments immediately. Nowadays, only few experienced urologists are able to recognize the kidney stone types in the images of the videos displayed on a screen during the endoscopy. Thus, several deep learning (DL) models have recently been proposed to automatically recognize the kidney stone types using ureteroscopic images. However, these DL models are of black box nature whicl limits their applicability in clinical settings. This contribution proposes a case-based reasoning DL model which uses prototypical parts (PPs) and generates local and global descriptors. The PPs encode for each class (i.e., kidney stone type) visual feature information (hue, saturation, intensity and textures) similar to that used by biologists. The PPs are optimally generated due a new loss function used during the model training. Moreover, the local and global descriptors of PPs allow to explain the decisions ("what" information, "where in the images") in an understandable way for biologists and urologists. The proposed DL model has been tested on a database including images of the six most widespread kidney stone types. The overall average classification accuracy was 90.37. When comparing this results with that of the eight other DL models of the kidney stone state-of-the-art, it can be seen that the valuable gain in explanability was not reached at the expense of accuracy which was even slightly increased with respect to that (88.2) of the best method of the literature. These promising and interpretable results also encourage urologists to put their trust in AI-based solutions.

Denoising Diffusion Models (DDMs) have become a popular tool for generating high-quality samples from complex data distributions. These models are able to capture sophisticated patterns and structures in the data, and can generate samples that are highly diverse and representative of the underlying distribution. However, one of the main limitations of diffusion models is the complexity of sample generation, since a large number of inference timesteps is required to faithfully capture the data distribution. In this paper, we present MMD-DDM, a novel method for fast sampling of diffusion models. Our approach is based on the idea of using the Maximum Mean Discrepancy (MMD) to finetune the learned distribution with a given budget of timesteps. This allows the finetuned model to significantly improve the speed-quality trade-off, by substantially increasing fidelity in inference regimes with few steps or, equivalently, by reducing the required number of steps to reach a target fidelity, thus paving the way for a more practical adoption of diffusion models in a wide range of applications. We evaluate our approach on unconditional image generation with extensive experiments across the CIFAR-10, CelebA, ImageNet and LSUN-Church datasets. Our findings show that the proposed method is able to produce high-quality samples in a fraction of the time required by widely-used diffusion models, and outperforms state-of-the-art techniques for accelerated sampling. Code is available at: https://github.com/diegovalsesia/MMD-DDM.

Large language models (LLMs) have demonstrated impressive capabilities in disease diagnosis. However, their effectiveness in identifying rarer diseases, which are inherently more challenging to diagnose, remains an open question. Rare disease performance is critical with the increasing use of LLMs in healthcare settings. This is especially true if a primary care physician needs to make a rarer prognosis from only a patient conversation so that they can take the appropriate next step. To that end, several clinical decision support systems are designed to support providers in rare disease identification. Yet their utility is limited due to their lack of knowledge of common disorders and difficulty of use. In this paper, we propose RareScale to combine the knowledge LLMs with expert systems. We use jointly use an expert system and LLM to simulate rare disease chats. This data is used to train a rare disease candidate predictor model. Candidates from this smaller model are then used as additional inputs to black-box LLM to make the final differential diagnosis. Thus, RareScale allows for a balance between rare and common diagnoses. We present results on over 575 rare diseases, beginning with Abdominal Actinomycosis and ending with Wilson's Disease. Our approach significantly improves the baseline performance of black-box LLMs by over 17% in Top-5 accuracy. We also find that our candidate generation performance is high (e.g. 88.8% on gpt-4o generated chats).

Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).

Cervical disc herniation (CDH) is a prevalent musculoskeletal disorder that significantly impacts health and requires labor-intensive analysis from experts. Despite advancements in automated detection of medical imaging, two significant challenges hinder the real-world application of these methods. First, the computational complexity and resource demands present a significant gap for real-time application. Second, noise in MRI reduces the effectiveness of existing methods by distorting feature extraction. To address these challenges, we propose three key contributions: Firstly, we introduced MedDet, which leverages the multi-teacher single-student knowledge distillation for model compression and efficiency, meanwhile integrating generative adversarial training to enhance performance. Additionally, we customize the second-order nmODE to improve the model's resistance to noise in MRI. Lastly, we conducted comprehensive experiments on the CDH-1848 dataset, achieving up to a 5% improvement in mAP compared to previous methods. Our approach also delivers over 5 times faster inference speed, with approximately 67.8% reduction in parameters and 36.9% reduction in FLOPs compared to the teacher model. These advancements significantly enhance the performance and efficiency of automated CDH detection, demonstrating promising potential for future application in clinical practice. See project website https://steve-zeyu-zhang.github.io/MedDet

This article provides a mathematically rigorous introduction to denoising diffusion probabilistic models (DDPMs), sometimes also referred to as diffusion probabilistic models or diffusion models, for generative artificial intelligence. We provide a detailed basic mathematical framework for DDPMs and explain the main ideas behind training and generation procedures. In this overview article we also review selected extensions and improvements of the basic framework from the literature such as improved DDPMs, denoising diffusion implicit models, classifier-free diffusion guidance models, and latent diffusion models.

Denoising Diffusion Probabilistic Models (DDPMs) have garnered popularity for data generation across various domains. However, a significant bottleneck is the necessity for whole-network computation during every step of the generative process, leading to high computational overheads. This paper presents a novel framework, Denoising Diffusion Step-aware Models (DDSM), to address this challenge. Unlike conventional approaches, DDSM employs a spectrum of neural networks whose sizes are adapted according to the importance of each generative step, as determined through evolutionary search. This step-wise network variation effectively circumvents redundant computational efforts, particularly in less critical steps, thereby enhancing the efficiency of the diffusion model. Furthermore, the step-aware design can be seamlessly integrated with other efficiency-geared diffusion models such as DDIMs and latent diffusion, thus broadening the scope of computational savings. Empirical evaluations demonstrate that DDSM achieves computational savings of 49% for CIFAR-10, 61% for CelebA-HQ, 59% for LSUN-bedroom, 71% for AFHQ, and 76% for ImageNet, all without compromising the generation quality. Our code and models will be publicly available.

Classifier-free guidance (CFG) is a fundamental tool in modern diffusion models for text-guided generation. Although effective, CFG has notable drawbacks. For instance, DDIM with CFG lacks invertibility, complicating image editing; furthermore, high guidance scales, essential for high-quality outputs, frequently result in issues like mode collapse. Contrary to the widespread belief that these are inherent limitations of diffusion models, this paper reveals that the problems actually stem from the off-manifold phenomenon associated with CFG, rather than the diffusion models themselves. More specifically, inspired by the recent advancements of diffusion model-based inverse problem solvers (DIS), we reformulate text-guidance as an inverse problem with a text-conditioned score matching loss, and develop CFG++, a novel approach that tackles the off-manifold challenges inherent in traditional CFG. CFG++ features a surprisingly simple fix to CFG, yet it offers significant improvements, including better sample quality for text-to-image generation, invertibility, smaller guidance scales, reduced mode collapse, etc. Furthermore, CFG++ enables seamless interpolation between unconditional and conditional sampling at lower guidance scales, consistently outperforming traditional CFG at all scales. Experimental results confirm that our method significantly enhances performance in text-to-image generation, DDIM inversion, editing, and solving inverse problems, suggesting a wide-ranging impact and potential applications in various fields that utilize text guidance. Project Page: https://cfgpp-diffusion.github.io/.

Computed tomography (CT) serves as an effective tool for lung cancer screening, diagnosis, treatment, and prognosis, providing a rich source of features to quantify temporal and spatial tumor changes. Nonetheless, the diversity of CT scanners and customized acquisition protocols can introduce significant inconsistencies in texture features, even when assessing the same patient. This variability poses a fundamental challenge for subsequent research that relies on consistent image features. Existing CT image standardization models predominantly utilize GAN-based supervised or semi-supervised learning, but their performance remains limited. We present DiffusionCT, an innovative score-based DDPM model that operates in the latent space to transform disparate non-standard distributions into a standardized form. The architecture comprises a U-Net-based encoder-decoder, augmented by a DDPM model integrated at the bottleneck position. First, the encoder-decoder is trained independently, without embedding DDPM, to capture the latent representation of the input data. Second, the latent DDPM model is trained while keeping the encoder-decoder parameters fixed. Finally, the decoder uses the transformed latent representation to generate a standardized CT image, providing a more consistent basis for downstream analysis. Empirical tests on patient CT images indicate notable improvements in image standardization using DiffusionCT. Additionally, the model significantly reduces image noise in SPAD images, further validating the effectiveness of DiffusionCT for advanced imaging tasks.

Multi-modality image fusion aims to combine different modalities to produce fused images that retain the complementary features of each modality, such as functional highlights and texture details. To leverage strong generative priors and address challenges such as unstable training and lack of interpretability for GAN-based generative methods, we propose a novel fusion algorithm based on the denoising diffusion probabilistic model (DDPM). The fusion task is formulated as a conditional generation problem under the DDPM sampling framework, which is further divided into an unconditional generation subproblem and a maximum likelihood subproblem. The latter is modeled in a hierarchical Bayesian manner with latent variables and inferred by the expectation-maximization (EM) algorithm. By integrating the inference solution into the diffusion sampling iteration, our method can generate high-quality fused images with natural image generative priors and cross-modality information from source images. Note that all we required is an unconditional pre-trained generative model, and no fine-tuning is needed. Our extensive experiments indicate that our approach yields promising fusion results in infrared-visible image fusion and medical image fusion. The code is available at https://github.com/Zhaozixiang1228/MMIF-DDFM.

Discrete diffusion or flow models could enable faster and more controllable sequence generation than autoregressive models. We show that na\"ive linear flow matching on the simplex is insufficient toward this goal since it suffers from discontinuities in the training target and further pathologies. To overcome this, we develop Dirichlet flow matching on the simplex based on mixtures of Dirichlet distributions as probability paths. In this framework, we derive a connection between the mixtures' scores and the flow's vector field that allows for classifier and classifier-free guidance. Further, we provide distilled Dirichlet flow matching, which enables one-step sequence generation with minimal performance hits, resulting in O(L) speedups compared to autoregressive models. On complex DNA sequence generation tasks, we demonstrate superior performance compared to all baselines in distributional metrics and in achieving desired design targets for generated sequences. Finally, we show that our classifier-free guidance approach improves unconditional generation and is effective for generating DNA that satisfies design targets. Code is available at https://github.com/HannesStark/dirichlet-flow-matching.

Denoising Diffusion Probabilistic Models (DDPMs) achieve state-of-the-art performance in synthesizing new images from random noise, but they lack meaningful latent space that encodes data into features. Recent DDPM-based editing techniques try to mitigate this issue by inverting images back to their approximated staring noise. In this work, we study the relation between the initial Gaussian noise, the samples generated from it, and their corresponding latent encodings obtained through the inversion procedure. First, we interpret their spatial distance relations to show the inaccuracy of the DDIM inversion technique by localizing latent representations manifold between the initial noise and generated samples. Then, we demonstrate the peculiar relation between initial Gaussian noise and its corresponding generations during diffusion training, showing that the high-level features of generated images stabilize rapidly, keeping the spatial distance relationship between noises and generations consistent throughout the training.

Breast ultrasound (BUS) is a critical diagnostic tool in the field of breast imaging, aiding in the early detection and characterization of breast abnormalities. Interpreting breast ultrasound images commonly involves creating comprehensive medical reports, containing vital information to promptly assess the patient's condition. However, the ultrasound imaging system necessitates capturing multiple images of various parts to compile a single report, presenting a time-consuming challenge. To address this problem, we propose the integration of multiple image analysis tools through a LangChain using Large Language Models (LLM), into the breast reporting process. Through a combination of designated tools and text generation through LangChain, our method can accurately extract relevant features from ultrasound images, interpret them in a clinical context, and produce comprehensive and standardized reports. This approach not only reduces the burden on radiologists and healthcare professionals but also enhances the consistency and quality of reports. The extensive experiments shows that each tools involved in the proposed method can offer qualitatively and quantitatively significant results. Furthermore, clinical evaluation on the generated reports demonstrates that the proposed method can make report in clinically meaningful way.

In this paper, we introduce InMD-X, a collection of multiple large language models specifically designed to cater to the unique characteristics and demands of Internal Medicine Doctors (IMD). InMD-X represents a groundbreaking development in natural language processing, offering a suite of language models fine-tuned for various aspects of the internal medicine field. These models encompass a wide range of medical sub-specialties, enabling IMDs to perform more efficient and accurate research, diagnosis, and documentation. InMD-X's versatility and adaptability make it a valuable tool for improving the healthcare industry, enhancing communication between healthcare professionals, and advancing medical research. Each model within InMD-X is meticulously tailored to address specific challenges faced by IMDs, ensuring the highest level of precision and comprehensiveness in clinical text analysis and decision support. This paper provides an overview of the design, development, and evaluation of InMD-X, showcasing its potential to revolutionize the way internal medicine practitioners interact with medical data and information. We present results from extensive testing, demonstrating the effectiveness and practical utility of InMD-X in real-world medical scenarios.

Chest X-rays (CXR) are the most common medical imaging study and are used to diagnose multiple medical conditions. This study examines the impact of synthetic data supplementation, using diffusion models, on the performance of deep learning (DL) classifiers for CXR analysis. We employed three datasets: CheXpert, MIMIC-CXR, and Emory Chest X-ray, training conditional denoising diffusion probabilistic models (DDPMs) to generate synthetic frontal radiographs. Our approach ensured that synthetic images mirrored the demographic and pathological traits of the original data. Evaluating the classifiers' performance on internal and external datasets revealed that synthetic data supplementation enhances model accuracy, particularly in detecting less prevalent pathologies. Furthermore, models trained on synthetic data alone approached the performance of those trained on real data. This suggests that synthetic data can potentially compensate for real data shortages in training robust DL models. However, despite promising outcomes, the superiority of real data persists.

Domain Generation Algorithms (DGAs) are malicious techniques used by malware to dynamically generate seemingly random domain names for communication with Command & Control (C&C) servers. Due to the fast and simple generation of DGA domains, detection methods must be highly efficient and precise to be effective. Large Language Models (LLMs) have demonstrated their proficiency in real-time detection tasks, making them ideal candidates for detecting DGAs. Our work validates the effectiveness of fine-tuned LLMs for detecting DGAs and DNS exfiltration attacks. We developed LLM models and conducted comprehensive evaluation using a diverse dataset comprising 59 distinct real-world DGA malware families and normal domain data. Our LLM model significantly outperformed traditional natural language processing techniques, especially in detecting unknown DGAs. We also evaluated its performance on DNS exfiltration datasets, demonstrating its effectiveness in enhancing cybersecurity measures. To the best of our knowledge, this is the first work that empirically applies LLMs for DGA and DNS exfiltration detection.

Denoising diffusion probabilistic models (DDPMs) employ a sequence of white Gaussian noise samples to generate an image. In analogy with GANs, those noise maps could be considered as the latent code associated with the generated image. However, this native noise space does not possess a convenient structure, and is thus challenging to work with in editing tasks. Here, we propose an alternative latent noise space for DDPM that enables a wide range of editing operations via simple means, and present an inversion method for extracting these edit-friendly noise maps for any given image (real or synthetically generated). As opposed to the native DDPM noise space, the edit-friendly noise maps do not have a standard normal distribution and are not statistically independent across timesteps. However, they allow perfect reconstruction of any desired image, and simple transformations on them translate into meaningful manipulations of the output image (e.g., shifting, color edits). Moreover, in text-conditional models, fixing those noise maps while changing the text prompt, modifies semantics while retaining structure. We illustrate how this property enables text-based editing of real images via the diverse DDPM sampling scheme (in contrast to the popular non-diverse DDIM inversion). We also show how it can be used within existing diffusion-based editing methods to improve their quality and diversity.

Denoising diffusion probabilistic models (DDPMs) have achieved high quality image generation without adversarial training, yet they require simulating a Markov chain for many steps to produce a sample. To accelerate sampling, we present denoising diffusion implicit models (DDIMs), a more efficient class of iterative implicit probabilistic models with the same training procedure as DDPMs. In DDPMs, the generative process is defined as the reverse of a Markovian diffusion process. We construct a class of non-Markovian diffusion processes that lead to the same training objective, but whose reverse process can be much faster to sample from. We empirically demonstrate that DDIMs can produce high quality samples 10 times to 50 times faster in terms of wall-clock time compared to DDPMs, allow us to trade off computation for sample quality, and can perform semantically meaningful image interpolation directly in the latent space.

Background: Health datasets from clinical sources do not reflect the breadth and diversity of disease in the real world, impacting research, medical education, and artificial intelligence (AI) tool development. Dermatology is a suitable area to develop and test a new and scalable method to create representative health datasets. Methods: We used Google Search advertisements to invite contributions to an open access dataset of images of dermatology conditions, demographic and symptom information. With informed contributor consent, we describe and release this dataset containing 10,408 images from 5,033 contributions from internet users in the United States over 8 months starting March 2023. The dataset includes dermatologist condition labels as well as estimated Fitzpatrick Skin Type (eFST) and Monk Skin Tone (eMST) labels for the images. Results: We received a median of 22 submissions/day (IQR 14-30). Female (66.72%) and younger (52% < age 40) contributors had a higher representation in the dataset compared to the US population, and 32.6% of contributors reported a non-White racial or ethnic identity. Over 97.5% of contributions were genuine images of skin conditions. Dermatologist confidence in assigning a differential diagnosis increased with the number of available variables, and showed a weaker correlation with image sharpness (Spearman's P values <0.001 and 0.01 respectively). Most contributions were short-duration (54% with onset < 7 days ago ) and 89% were allergic, infectious, or inflammatory conditions. eFST and eMST distributions reflected the geographical origin of the dataset. The dataset is available at github.com/google-research-datasets/scin . Conclusion: Search ads are effective at crowdsourcing images of health conditions. The SCIN dataset bridges important gaps in the availability of representative images of common skin conditions.

Denoising diffusion probabilistic models (DDPM) have shown remarkable performance in unconditional image generation. However, due to the stochasticity of the generative process in DDPM, it is challenging to generate images with the desired semantics. In this work, we propose Iterative Latent Variable Refinement (ILVR), a method to guide the generative process in DDPM to generate high-quality images based on a given reference image. Here, the refinement of the generative process in DDPM enables a single DDPM to sample images from various sets directed by the reference image. The proposed ILVR method generates high-quality images while controlling the generation. The controllability of our method allows adaptation of a single DDPM without any additional learning in various image generation tasks, such as generation from various downsampling factors, multi-domain image translation, paint-to-image, and editing with scribbles.

Generating synthetic datasets for training face recognition models is challenging because dataset generation entails more than creating high fidelity images. It involves generating multiple images of same subjects under different factors (e.g., variations in pose, illumination, expression, aging and occlusion) which follows the real image conditional distribution. Previous works have studied the generation of synthetic datasets using GAN or 3D models. In this work, we approach the problem from the aspect of combining subject appearance (ID) and external factor (style) conditions. These two conditions provide a direct way to control the inter-class and intra-class variations. To this end, we propose a Dual Condition Face Generator (DCFace) based on a diffusion model. Our novel Patch-wise style extractor and Time-step dependent ID loss enables DCFace to consistently produce face images of the same subject under different styles with precise control. Face recognition models trained on synthetic images from the proposed DCFace provide higher verification accuracies compared to previous works by 6.11% on average in 4 out of 5 test datasets, LFW, CFP-FP, CPLFW, AgeDB and CALFW. Code is available at https://github.com/mk-minchul/dcface

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

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Automating radiology report generation can significantly alleviate radiologists' workloads. Previous research has primarily focused on realizing highly concise observations while neglecting the precise attributes that determine the severity of diseases (e.g., small pleural effusion). Since incorrect attributes will lead to imprecise radiology reports, strengthening the generation process with precise attribute modeling becomes necessary. Additionally, the temporal information contained in the historical records, which is crucial in evaluating a patient's current condition (e.g., heart size is unchanged), has also been largely disregarded. To address these issues, we propose RECAP, which generates precise and accurate radiology reports via dynamic disease progression reasoning. Specifically, RECAP first predicts the observations and progressions (i.e., spatiotemporal information) given two consecutive radiographs. It then combines the historical records, spatiotemporal information, and radiographs for report generation, where a disease progression graph and dynamic progression reasoning mechanism are devised to accurately select the attributes of each observation and progression. Extensive experiments on two publicly available datasets demonstrate the effectiveness of our model.

While likelihood-based generative models, particularly diffusion and autoregressive models, have achieved remarkable fidelity in visual generation, the maximum likelihood estimation (MLE) objective inherently suffers from a mode-covering tendency that limits the generation quality under limited model capacity. In this work, we propose Direct Discriminative Optimization (DDO) as a unified framework that bridges likelihood-based generative training and the GAN objective to bypass this fundamental constraint. Our key insight is to parameterize a discriminator implicitly using the likelihood ratio between a learnable target model and a fixed reference model, drawing parallels with the philosophy of Direct Preference Optimization (DPO). Unlike GANs, this parameterization eliminates the need for joint training of generator and discriminator networks, allowing for direct, efficient, and effective finetuning of a well-trained model to its full potential beyond the limits of MLE. DDO can be performed iteratively in a self-play manner for progressive model refinement, with each round requiring less than 1% of pretraining epochs. Our experiments demonstrate the effectiveness of DDO by significantly advancing the previous SOTA diffusion model EDM, reducing FID scores from 1.79/1.58 to new records of 1.30/0.97 on CIFAR-10/ImageNet-64 datasets, and by consistently improving both guidance-free and CFG-enhanced FIDs of visual autoregressive models on ImageNet 256times256.

Recent approaches have shown promises distilling diffusion models into efficient one-step generators. Among them, Distribution Matching Distillation (DMD) produces one-step generators that match their teacher in distribution, without enforcing a one-to-one correspondence with the sampling trajectories of their teachers. However, to ensure stable training, DMD requires an additional regression loss computed using a large set of noise-image pairs generated by the teacher with many steps of a deterministic sampler. This is costly for large-scale text-to-image synthesis and limits the student's quality, tying it too closely to the teacher's original sampling paths. We introduce DMD2, a set of techniques that lift this limitation and improve DMD training. First, we eliminate the regression loss and the need for expensive dataset construction. We show that the resulting instability is due to the fake critic not estimating the distribution of generated samples accurately and propose a two time-scale update rule as a remedy. Second, we integrate a GAN loss into the distillation procedure, discriminating between generated samples and real images. This lets us train the student model on real data, mitigating the imperfect real score estimation from the teacher model, and enhancing quality. Lastly, we modify the training procedure to enable multi-step sampling. We identify and address the training-inference input mismatch problem in this setting, by simulating inference-time generator samples during training time. Taken together, our improvements set new benchmarks in one-step image generation, with FID scores of 1.28 on ImageNet-64x64 and 8.35 on zero-shot COCO 2014, surpassing the original teacher despite a 500X reduction in inference cost. Further, we show our approach can generate megapixel images by distilling SDXL, demonstrating exceptional visual quality among few-step methods.

Distillation techniques have substantially improved the sampling speed of diffusion models, allowing of the generation within only one step or a few steps. However, these distillation methods require extensive training for each dataset, sampler, and network, which limits their practical applicability. To address this limitation, we propose a straightforward distillation approach, Distilled-ODE solvers (D-ODE solvers), that optimizes the ODE solver rather than training the denoising network. D-ODE solvers are formulated by simply applying a single parameter adjustment to existing ODE solvers. Subsequently, D-ODE solvers with smaller steps are optimized by ODE solvers with larger steps through distillation over a batch of samples. Our comprehensive experiments indicate that D-ODE solvers outperform existing ODE solvers, including DDIM, PNDM, DPM-Solver, DEIS, and EDM, especially when generating samples with fewer steps. Our method incur negligible computational overhead compared to previous distillation techniques, enabling simple and rapid integration with previous samplers. Qualitative analysis further shows that D-ODE solvers enhance image quality while preserving the sampling trajectory of ODE solvers.

This paper introduces a novel framework for DNA sequence generation, comprising two key components: DiscDiff, a Latent Diffusion Model (LDM) tailored for generating discrete DNA sequences, and Absorb-Escape, a post-training algorithm designed to refine these sequences. Absorb-Escape enhances the realism of the generated sequences by correcting `round errors' inherent in the conversion process between latent and input spaces. Our approach not only sets new standards in DNA sequence generation but also demonstrates superior performance over existing diffusion models, in generating both short and long DNA sequences. Additionally, we introduce EPD-GenDNA, the first comprehensive, multi-species dataset for DNA generation, encompassing 160,000 unique sequences from 15 species. We hope this study will advance the generative modelling of DNA, with potential implications for gene therapy and protein production.

This paper introduces diffusion protein language model (DPLM), a versatile protein language model that demonstrates strong generative and predictive capabilities for protein sequences. We first pre-train scalable DPLMs from evolutionary-scale protein sequences within a generative self-supervised discrete diffusion probabilistic framework, which generalizes language modeling for proteins in a principled way. After pre-training, DPLM exhibits the ability to generate structurally plausible, novel, and diverse protein sequences for unconditional generation. We further demonstrate the proposed diffusion generative pre-training makes DPLM possess a better understanding of proteins, making it a superior representation learner, which can be fine-tuned for various predictive tasks, comparing favorably to ESM2 (Lin et al., 2022). Moreover, DPLM can be tailored for various needs, which showcases its prowess of conditional generation in several ways: (1) conditioning on partial peptide sequences, e.g., generating scaffolds for functional motifs with high success rate; (2) incorporating other modalities as conditioner, e.g., structure-conditioned generation for inverse folding; and (3) steering sequence generation towards desired properties, e.g., satisfying specified secondary structures, through a plug-and-play classifier guidance. Code is released at https://github.com/bytedance/dplm.

Traditional Chinese medicine (TCM) plays a vital role in health protection and disease treatment, but its practical application requires extensive medical knowledge and clinical experience. Existing TCM Large Language Models (LLMs) exhibit critical limitations of uncomprehensive medical consultation and diagnoses, and inaccurate syndrome differentiation-based treatment. To address these issues, this study establishes JingFang (JF): a novel TCM Large Language Model that demonstrates the expert-level capability of medical diagnosis and syndrome differentiation-based treatment. We innovate a Multi-agent Dynamic Collaborative Chain-of-Thought Mechanism (MDCCTM) for medical consultation, enabling JF with effective and accurate diagnostic ability. In addition, a Syndrome Agent and a Dual-Stage Retrieval Scheme (DSRS) are developed to significantly enhance the capacity of JF for disease treatment based on syndrome differentiation. JingFang not only facilitates the application of LLMs but also promotes the effective practice of TCM in human health protection and disease treatment.

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

This report presents the comprehensive implementation, evaluation, and optimization of Denoising Diffusion Probabilistic Models (DDPMs) and Denoising Diffusion Implicit Models (DDIMs), which are state-of-the-art generative models. During inference, these models take random noise as input and iteratively generate high-quality images as output. The study focuses on enhancing their generative capabilities by incorporating advanced techniques such as Classifier-Free Guidance (CFG), Latent Diffusion Models with Variational Autoencoders (VAE), and alternative noise scheduling strategies. The motivation behind this work is the growing demand for efficient and scalable generative AI models that can produce realistic images across diverse datasets, addressing challenges in applications such as art creation, image synthesis, and data augmentation. Evaluations were conducted on datasets including CIFAR-10 and ImageNet-100, with a focus on improving inference speed, computational efficiency, and image quality metrics like Frechet Inception Distance (FID). Results demonstrate that DDIM + CFG achieves faster inference and superior image quality. Challenges with VAE and noise scheduling are also highlighted, suggesting opportunities for future optimization. This work lays the groundwork for developing scalable, efficient, and high-quality generative AI systems to benefit industries ranging from entertainment to robotics.

Current diffusion-based image restoration methods feed degraded input images as conditions into the noise estimation network. However, interpreting this diffusion process is challenging since it essentially generates the target image from the noise. To establish a unified and more interpretable model for image generation and restoration, we propose residual denoising diffusion models (RDDM). In contrast to existing diffusion models (e.g., DDPM or DDIM) that focus solely on noise estimation, our RDDM predicts residuals to represent directional diffusion from the target domain to the input domain, while concurrently estimating noise to account for random perturbations in the diffusion process. The introduction of residuals allows us to redefine the forward diffusion process, wherein the target image progressively diffuses into a purely noisy image or a noise-carrying input image, thus unifying image generation and restoration. We demonstrate that our sampling process is consistent with that of DDPM and DDIM through coefficient transformation, and propose a partially path-independent generation process to better understand the reverse process. Notably, with native support for conditional inputs, our RDDM enables a generic UNet, trained with only an ell _1 loss and a batch size of 1, to compete with state-of-the-art image restoration methods. We provide code and pre-trained models to encourage further exploration, application, and development of our innovative framework (https://github.com/nachifur/RDDM).

Diffusion probabilistic models (DPMs) have achieved impressive success in high-resolution image synthesis, especially in recent large-scale text-to-image generation applications. An essential technique for improving the sample quality of DPMs is guided sampling, which usually needs a large guidance scale to obtain the best sample quality. The commonly-used fast sampler for guided sampling is DDIM, a first-order diffusion ODE solver that generally needs 100 to 250 steps for high-quality samples. Although recent works propose dedicated high-order solvers and achieve a further speedup for sampling without guidance, their effectiveness for guided sampling has not been well-tested before. In this work, we demonstrate that previous high-order fast samplers suffer from instability issues, and they even become slower than DDIM when the guidance scale grows large. To further speed up guided sampling, we propose DPM-Solver++, a high-order solver for the guided sampling of DPMs. DPM-Solver++ solves the diffusion ODE with the data prediction model and adopts thresholding methods to keep the solution matches training data distribution. We further propose a multistep variant of DPM-Solver++ to address the instability issue by reducing the effective step size. Experiments show that DPM-Solver++ can generate high-quality samples within only 15 to 20 steps for guided sampling by pixel-space and latent-space DPMs.

Test case generation is an important activity, yet a time-consuming and laborious task. Recently, AthenaTest -- a deep learning approach for generating unit test cases -- is proposed. However, AthenaTest can generate less than one-fifth of the test cases correctly, due to a lack of assertion knowledge and test signature verification. In this paper, we propose A3Test, a DL-based test case generation approach that is augmented by assertion knowledge with a mechanism to verify naming consistency and test signatures. A3Test leverages the domain adaptation principles where the goal is to adapt the existing knowledge from an assertion generation task to the test case generation task. We also introduce a verification approach to verify naming consistency and test signatures. Through an evaluation of 5,278 focal methods from the Defects4j dataset, we find that our A3Test (1) achieves 147% more correct test cases and 15% more method coverage, with a lower number of generated test cases than AthenaTest; (2) still outperforms the existing pre-trained models for the test case generation task; (3) contributes substantially to performance improvement via our own proposed assertion pre-training and the verification components; (4) is 97.2% much faster while being more accurate than AthenaTest.

Deep learning (DL) has proven highly effective for ultrasound-based computer-aided diagnosis (CAD) of breast cancers. In an automaticCAD system, lesion detection is critical for the following diagnosis. However, existing DL-based methods generally require voluminous manually-annotated region of interest (ROI) labels and class labels to train both the lesion detection and diagnosis models. In clinical practice, the ROI labels, i.e. ground truths, may not always be optimal for the classification task due to individual experience of sonologists, resulting in the issue of coarse annotation that limits the diagnosis performance of a CAD model. To address this issue, a novel Two-Stage Detection and Diagnosis Network (TSDDNet) is proposed based on weakly supervised learning to enhance diagnostic accuracy of the ultrasound-based CAD for breast cancers. In particular, all the ROI-level labels are considered as coarse labels in the first training stage, and then a candidate selection mechanism is designed to identify optimallesion areas for both the fully and partially annotated samples. It refines the current ROI-level labels in the fully annotated images and the detected ROIs in the partially annotated samples with a weakly supervised manner under the guidance of class labels. In the second training stage, a self-distillation strategy further is further proposed to integrate the detection network and classification network into a unified framework as the final CAD model for joint optimization, which then further improves the diagnosis performance. The proposed TSDDNet is evaluated on a B-mode ultrasound dataset, and the experimental results show that it achieves the best performance on both lesion detection and diagnosis tasks, suggesting promising application potential.

Human organs constantly undergo anatomical changes due to a complex mix of short-term (e.g., heartbeat) and long-term (e.g., aging) factors. Evidently, prior knowledge of these factors will be beneficial when modeling their future state, i.e., via image generation. However, most of the medical image generation tasks only rely on the input from a single image, thus ignoring the sequential dependency even when longitudinal data is available. Sequence-aware deep generative models, where model input is a sequence of ordered and timestamped images, are still underexplored in the medical imaging domain that is featured by several unique challenges: 1) Sequences with various lengths; 2) Missing data or frame, and 3) High dimensionality. To this end, we propose a sequence-aware diffusion model (SADM) for the generation of longitudinal medical images. Recently, diffusion models have shown promising results in high-fidelity image generation. Our method extends this new technique by introducing a sequence-aware transformer as the conditional module in a diffusion model. The novel design enables learning longitudinal dependency even with missing data during training and allows autoregressive generation of a sequence of images during inference. Our extensive experiments on 3D longitudinal medical images demonstrate the effectiveness of SADM compared with baselines and alternative methods. The code is available at https://github.com/ubc-tea/SADM-Longitudinal-Medical-Image-Generation.

This paper introduces an innovative methodology for producing high-quality 3D lung CT images guided by textual information. While diffusion-based generative models are increasingly used in medical imaging, current state-of-the-art approaches are limited to low-resolution outputs and underutilize radiology reports' abundant information. The radiology reports can enhance the generation process by providing additional guidance and offering fine-grained control over the synthesis of images. Nevertheless, expanding text-guided generation to high-resolution 3D images poses significant memory and anatomical detail-preserving challenges. Addressing the memory issue, we introduce a hierarchical scheme that uses a modified UNet architecture. We start by synthesizing low-resolution images conditioned on the text, serving as a foundation for subsequent generators for complete volumetric data. To ensure the anatomical plausibility of the generated samples, we provide further guidance by generating vascular, airway, and lobular segmentation masks in conjunction with the CT images. The model demonstrates the capability to use textual input and segmentation tasks to generate synthesized images. The results of comparative assessments indicate that our approach exhibits superior performance compared to the most advanced models based on GAN and diffusion techniques, especially in accurately retaining crucial anatomical features such as fissure lines, airways, and vascular structures. This innovation introduces novel possibilities. This study focuses on two main objectives: (1) the development of a method for creating images based on textual prompts and anatomical components, and (2) the capability to generate new images conditioning on anatomical elements. The advancements in image generation can be applied to enhance numerous downstream tasks.

Procedural Content Generation (PCG) is powerful in creating high-quality 3D contents, yet controlling it to produce desired shapes is difficult and often requires extensive parameter tuning. Inverse Procedural Content Generation aims to automatically find the best parameters under the input condition. However, existing sampling-based and neural network-based methods still suffer from numerous sample iterations or limited controllability. In this work, we present DI-PCG, a novel and efficient method for Inverse PCG from general image conditions. At its core is a lightweight diffusion transformer model, where PCG parameters are directly treated as the denoising target and the observed images as conditions to control parameter generation. DI-PCG is efficient and effective. With only 7.6M network parameters and 30 GPU hours to train, it demonstrates superior performance in recovering parameters accurately, and generalizing well to in-the-wild images. Quantitative and qualitative experiment results validate the effectiveness of DI-PCG in inverse PCG and image-to-3D generation tasks. DI-PCG offers a promising approach for efficient inverse PCG and represents a valuable exploration step towards a 3D generation path that models how to construct a 3D asset using parametric models.

Diffusion models have demonstrated excellent potential for generating diverse images. However, their performance often suffers from slow generation due to iterative denoising. Knowledge distillation has been recently proposed as a remedy that can reduce the number of inference steps to one or a few without significant quality degradation. However, existing distillation methods either require significant amounts of offline computation for generating synthetic training data from the teacher model or need to perform expensive online learning with the help of real data. In this work, we present a novel technique called BOOT, that overcomes these limitations with an efficient data-free distillation algorithm. The core idea is to learn a time-conditioned model that predicts the output of a pre-trained diffusion model teacher given any time step. Such a model can be efficiently trained based on bootstrapping from two consecutive sampled steps. Furthermore, our method can be easily adapted to large-scale text-to-image diffusion models, which are challenging for conventional methods given the fact that the training sets are often large and difficult to access. We demonstrate the effectiveness of our approach on several benchmark datasets in the DDIM setting, achieving comparable generation quality while being orders of magnitude faster than the diffusion teacher. The text-to-image results show that the proposed approach is able to handle highly complex distributions, shedding light on more efficient generative modeling.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

Diffusion models are powerful generative models that map noise to data using stochastic processes. However, for many applications such as image editing, the model input comes from a distribution that is not random noise. As such, diffusion models must rely on cumbersome methods like guidance or projected sampling to incorporate this information in the generative process. In our work, we propose Denoising Diffusion Bridge Models (DDBMs), a natural alternative to this paradigm based on diffusion bridges, a family of processes that interpolate between two paired distributions given as endpoints. Our method learns the score of the diffusion bridge from data and maps from one endpoint distribution to the other by solving a (stochastic) differential equation based on the learned score. Our method naturally unifies several classes of generative models, such as score-based diffusion models and OT-Flow-Matching, allowing us to adapt existing design and architectural choices to our more general problem. Empirically, we apply DDBMs to challenging image datasets in both pixel and latent space. On standard image translation problems, DDBMs achieve significant improvement over baseline methods, and, when we reduce the problem to image generation by setting the source distribution to random noise, DDBMs achieve comparable FID scores to state-of-the-art methods despite being built for a more general task.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

Synthetic data generation offers a promising solution to enhance the usefulness of Electronic Healthcare Records (EHR) by generating realistic de-identified data. However, the existing literature primarily focuses on the quality of synthetic health data, neglecting the crucial aspect of fairness in downstream predictions. Consequently, models trained on synthetic EHR have faced criticism for producing biased outcomes in target tasks. These biases can arise from either spurious correlations between features or the failure of models to accurately represent sub-groups. To address these concerns, we present Bias-transforming Generative Adversarial Networks (Bt-GAN), a GAN-based synthetic data generator specifically designed for the healthcare domain. In order to tackle spurious correlations (i), we propose an information-constrained Data Generation Process that enables the generator to learn a fair deterministic transformation based on a well-defined notion of algorithmic fairness. To overcome the challenge of capturing exact sub-group representations (ii), we incentivize the generator to preserve sub-group densities through score-based weighted sampling. This approach compels the generator to learn from underrepresented regions of the data manifold. We conduct extensive experiments using the MIMIC-III database. Our results demonstrate that Bt-GAN achieves SOTA accuracy while significantly improving fairness and minimizing bias amplification. We also perform an in-depth explainability analysis to provide additional evidence supporting the validity of our study. In conclusion, our research introduces a novel and professional approach to addressing the limitations of synthetic data generation in the healthcare domain. By incorporating fairness considerations and leveraging advanced techniques such as GANs, we pave the way for more reliable and unbiased predictions in healthcare applications.

Denoising diffusion probabilistic models (DDPM) are a class of generative models which have recently been shown to produce excellent samples. We show that with a few simple modifications, DDPMs can also achieve competitive log-likelihoods while maintaining high sample quality. Additionally, we find that learning variances of the reverse diffusion process allows sampling with an order of magnitude fewer forward passes with a negligible difference in sample quality, which is important for the practical deployment of these models. We additionally use precision and recall to compare how well DDPMs and GANs cover the target distribution. Finally, we show that the sample quality and likelihood of these models scale smoothly with model capacity and training compute, making them easily scalable. We release our code at https://github.com/openai/improved-diffusion

In disentangling the heterogeneity observed in psychopathology, personality of the patients is considered crucial. While it has been demonstrated that personality traits are reflected in the language used by a patient, we hypothesize that this enables automatic inference of the personality type directly from speech utterances, potentially more accurately than through a traditional questionnaire-based approach explicitly designed for personality classification. To validate this hypothesis, we adopt natural language processing (NLP) and standard machine learning tools for classification. We test this on a dataset of recorded clinical diagnostic interviews (CDI) on a sample of 79 patients diagnosed with major depressive disorder (MDD) -- a condition for which differentiated treatment based on personality styles has been advocated -- and classified into anaclitic and introjective personality styles. We start by analyzing the interviews to see which linguistic features are associated with each style, in order to gain a better understanding of the styles. Then, we develop automatic classifiers based on (a) standardized questionnaire responses; (b) basic text features, i.e., TF-IDF scores of words and word sequences; (c) more advanced text features, using LIWC (linguistic inquiry and word count) and context-aware features using BERT (bidirectional encoder representations from transformers); (d) audio features. We find that automated classification with language-derived features (i.e., based on LIWC) significantly outperforms questionnaire-based classification models. Furthermore, the best performance is achieved by combining LIWC with the questionnaire features. This suggests that more work should be put into developing linguistically based automated techniques for characterizing personality, however questionnaires still to some extent complement such methods.

Latent diffusion models are the state-of-the-art for synthetic image generation. To align these models with human preferences, training the models using reinforcement learning on human feedback is crucial. Black et. al 2024 introduced denoising diffusion policy optimisation (DDPO), which accounts for the iterative denoising nature of the generation by modelling it as a Markov chain with a final reward. As the reward is a single value that determines the model's performance on the entire image, the model has to navigate a very sparse reward landscape and so requires a large sample count. In this work, we extend the DDPO by presenting the Pixel-wise Policy Optimisation (PXPO) algorithm, which can take feedback for each pixel, providing a more nuanced reward to the model.

Test-time adaptation harnesses test inputs to improve the accuracy of a model trained on source data when tested on shifted target data. Existing methods update the source model by (re-)training on each target domain. While effective, re-training is sensitive to the amount and order of the data and the hyperparameters for optimization. We instead update the target data, by projecting all test inputs toward the source domain with a generative diffusion model. Our diffusion-driven adaptation method, DDA, shares its models for classification and generation across all domains. Both models are trained on the source domain, then fixed during testing. We augment diffusion with image guidance and self-ensembling to automatically decide how much to adapt. Input adaptation by DDA is more robust than prior model adaptation approaches across a variety of corruptions, architectures, and data regimes on the ImageNet-C benchmark. With its input-wise updates, DDA succeeds where model adaptation degrades on too little data in small batches, dependent data in non-uniform order, or mixed data with multiple corruptions.

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

Generating differentially private (DP) synthetic data that closely resembles the original private data is a scalable way to mitigate privacy concerns in the current data-driven world. In contrast to current practices that train customized models for this task, we aim to generate DP Synthetic Data via APIs (DPSDA), where we treat foundation models as blackboxes and only utilize their inference APIs. Such API-based, training-free approaches are easier to deploy as exemplified by the recent surge in the number of API-based apps. These approaches can also leverage the power of large foundation models which are only accessible via their inference APIs. However, this comes with greater challenges due to strictly more restrictive model access and the need to protect privacy from the API provider. In this paper, we present a new framework called Private Evolution (PE) to solve this problem and show its initial promise on synthetic images. Surprisingly, PE can match or even outperform state-of-the-art (SOTA) methods without any model training. For example, on CIFAR10 (with ImageNet as the public data), we achieve FID <= 7.9 with privacy cost {\epsilon} = 0.67, significantly improving the previous SOTA from {\epsilon} = 32. We further demonstrate the promise of applying PE on large foundation models such as Stable Diffusion to tackle challenging private datasets with a small number of high-resolution images. The code and data are released at https://github.com/microsoft/DPSDA.

Voice conversion is a method that allows for the transformation of speaking style while maintaining the integrity of linguistic information. There are many researchers using deep generative models for voice conversion tasks. Generative Adversarial Networks (GANs) can quickly generate high-quality samples, but the generated samples lack diversity. The samples generated by the Denoising Diffusion Probabilistic Models (DDPMs) are better than GANs in terms of mode coverage and sample diversity. But the DDPMs have high computational costs and the inference speed is slower than GANs. In order to make GANs and DDPMs more practical we proposes DiffGAN-VC, a variant of GANs and DDPMS, to achieve non-parallel many-to-many voice conversion (VC). We use large steps to achieve denoising, and also introduce a multimodal conditional GANs to model the denoising diffusion generative adversarial network. According to both objective and subjective evaluation experiments, DiffGAN-VC has been shown to achieve high voice quality on non-parallel data sets. Compared with the CycleGAN-VC method, DiffGAN-VC achieves speaker similarity, naturalness and higher sound quality.

Layout generation is a task to synthesize a harmonious layout with elements characterized by attributes such as category, position, and size. Human designers experiment with the placement and modification of elements to create aesthetic layouts, however, we observed that current discrete diffusion models (DDMs) struggle to correct inharmonious layouts after they have been generated. In this paper, we first provide novel insights into layout sticking phenomenon in DDMs and then propose a simple yet effective layout-assessment module Layout-Corrector, which works in conjunction with existing DDMs to address the layout sticking problem. We present a learning-based module capable of identifying inharmonious elements within layouts, considering overall layout harmony characterized by complex composition. During the generation process, Layout-Corrector evaluates the correctness of each token in the generated layout, reinitializing those with low scores to the ungenerated state. The DDM then uses the high-scored tokens as clues to regenerate the harmonized tokens. Layout-Corrector, tested on common benchmarks, consistently boosts layout-generation performance when in conjunction with various state-of-the-art DDMs. Furthermore, our extensive analysis demonstrates that the Layout-Corrector (1) successfully identifies erroneous tokens, (2) facilitates control over the fidelity-diversity trade-off, and (3) significantly mitigates the performance drop associated with fast sampling.

High-quality, large-scale data is essential for robust deep learning models in medical applications, particularly ultrasound image analysis. Diffusion models facilitate high-fidelity medical image generation, reducing the costs associated with acquiring and annotating new images. This paper utilizes recent vision-language models to produce diverse and realistic synthetic echocardiography image data, preserving key features of the original images guided by textual and semantic label maps. Specifically, we investigate three potential avenues: unconditional generation, generation guided by text, and a hybrid approach incorporating both textual and semantic supervision. We show that the rich contextual information present in the synthesized data potentially enhances the accuracy and interpretability of downstream tasks, such as echocardiography segmentation and classification with improved metrics and faster convergence. Our implementation with checkpoints, prompts, and the created synthetic dataset will be publicly available at https://github.com/Pooria90/DiffEcho{GitHub}.

Chromosome classification is critical for karyotyping in abnormality diagnosis. To expedite the diagnosis, we present a novel method named Varifocal-Net for simultaneous classification of chromosome's type and polarity using deep convolutional networks. The approach consists of one global-scale network (G-Net) and one local-scale network (L-Net). It follows three stages. The first stage is to learn both global and local features. We extract global features and detect finer local regions via the G-Net. By proposing a varifocal mechanism, we zoom into local parts and extract local features via the L-Net. Residual learning and multi-task learning strategies are utilized to promote high-level feature extraction. The detection of discriminative local parts is fulfilled by a localization subnet of the G-Net, whose training process involves both supervised and weakly-supervised learning. The second stage is to build two multi-layer perceptron classifiers that exploit features of both two scales to boost classification performance. The third stage is to introduce a dispatch strategy of assigning each chromosome to a type within each patient case, by utilizing the domain knowledge of karyotyping. Evaluation results from 1909 karyotyping cases showed that the proposed Varifocal-Net achieved the highest accuracy per patient case (%) 99.2 for both type and polarity tasks. It outperformed state-of-the-art methods, demonstrating the effectiveness of our varifocal mechanism, multi-scale feature ensemble, and dispatch strategy. The proposed method has been applied to assist practical karyotype diagnosis.

This paper explores the task of radiology report generation, which aims at generating free-text descriptions for a set of radiographs. One significant challenge of this task is how to correctly maintain the consistency between the images and the lengthy report. Previous research explored solving this issue through planning-based methods, which generate reports only based on high-level plans. However, these plans usually only contain the major observations from the radiographs (e.g., lung opacity), lacking much necessary information, such as the observation characteristics and preliminary clinical diagnoses. To address this problem, the system should also take the image information into account together with the textual plan and perform stronger reasoning during the generation process. In this paper, we propose an observation-guided radiology report generation framework (ORGAN). It first produces an observation plan and then feeds both the plan and radiographs for report generation, where an observation graph and a tree reasoning mechanism are adopted to precisely enrich the plan information by capturing the multi-formats of each observation. Experimental results demonstrate that our framework outperforms previous state-of-the-art methods regarding text quality and clinical efficacy

Protein design with desirable properties has been a significant challenge for many decades. Generative artificial intelligence is a promising approach and has achieved great success in various protein generation tasks. Notably, diffusion models stand out for their robust mathematical foundations and impressive generative capabilities, offering unique advantages in certain applications such as protein design. In this review, we first give the definition and characteristics of diffusion models and then focus on two strategies: Denoising Diffusion Probabilistic Models and Score-based Generative Models, where DDPM is the discrete form of SGM. Furthermore, we discuss their applications in protein design, peptide generation, drug discovery, and protein-ligand interaction. Finally, we outline the future perspectives of diffusion models to advance autonomous protein design and engineering. The E(3) group consists of all rotations, reflections, and translations in three-dimensions. The equivariance on the E(3) group can keep the physical stability of the frame of each amino acid as much as possible, and we reflect on how to keep the diffusion model E(3) equivariant for protein generation.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Prostate cancer, a growing global health concern, necessitates precise diagnostic tools, with Magnetic Resonance Imaging (MRI) offering high-resolution soft tissue imaging that significantly enhances diagnostic accuracy. Recent advancements in explainable AI and representation learning have significantly improved prostate cancer diagnosis by enabling automated and precise lesion classification. However, existing explainable AI methods, particularly those based on frameworks like generative adversarial networks (GANs), are predominantly developed for natural image generation, and their application to medical imaging often leads to suboptimal performance due to the unique characteristics and complexity of medical image. To address these challenges, our paper introduces three key contributions. First, we propose ProjectedEx, a generative framework that provides interpretable, multi-attribute explanations, effectively linking medical image features to classifier decisions. Second, we enhance the encoder module by incorporating feature pyramids, which enables multiscale feedback to refine the latent space and improves the quality of generated explanations. Additionally, we conduct comprehensive experiments on both the generator and classifier, demonstrating the clinical relevance and effectiveness of ProjectedEx in enhancing interpretability and supporting the adoption of AI in medical settings. Code will be released at https://github.com/Richardqiyi/ProjectedEx

Reading and interpreting chest X-ray images is one of the most radiologist's routines. However, it still can be challenging, even for the most experienced ones. Therefore, we proposed a multi-model deep learning-based automated chest X-ray report generator system designed to assist radiologists in their work. The basic idea of the proposed system is by utilizing multi binary-classification models for detecting multi abnormalities, with each model responsible for detecting one abnormality, in a single image. In this study, we limited the radiology abnormalities detection to only cardiomegaly, lung effusion, and consolidation. The system generates a radiology report by performing the following three steps: image pre-processing, utilizing deep learning models to detect abnormalities, and producing a report. The aim of the image pre-processing step is to standardize the input by scaling it to 128x128 pixels and slicing it into three segments, which covers the upper, lower, and middle parts of the lung. After pre-processing, each corresponding model classifies the image, resulting in a 0 (zero) for no abnormality detected and a 1 (one) for the presence of an abnormality. The prediction outputs of each model are then concatenated to form a 'result code'. The 'result code' is used to construct a report by selecting the appropriate pre-determined sentence for each detected abnormality in the report generation step. The proposed system is expected to reduce the workload of radiologists and increase the accuracy of chest X-ray diagnosis.

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

Rare diseases present unique challenges in healthcare, often suffering from delayed diagnosis and fragmented information landscapes. The scarcity of reliable knowledge in these conditions poses a distinct challenge for Large Language Models (LLMs) in supporting clinical management and delivering precise patient information underscoring the need for focused training on these 'zebra' cases. We present Zebra-Llama, a specialized context-aware language model with high precision Retrieval Augmented Generation (RAG) capability, focusing on Ehlers-Danlos Syndrome (EDS) as our case study. EDS, affecting 1 in 5,000 individuals, exemplifies the complexities of rare diseases with its diverse symptoms, multiple subtypes, and evolving diagnostic criteria. By implementing a novel context-aware fine-tuning methodology trained on questions derived from medical literature, patient experiences, and clinical resources, along with expertly curated responses, Zebra-Llama demonstrates unprecedented capabilities in handling EDS-related queries. On a test set of real-world questions collected from EDS patients and clinicians, medical experts evaluated the responses generated by both models, revealing Zebra-Llama's substantial improvements over base model (Llama 3.1-8B-Instruct) in thoroughness (77.5% vs. 70.1%), accuracy (83.0% vs. 78.8%), clarity (74.7% vs. 72.0%) and citation reliability (70.6% vs. 52.3%). Released as an open-source resource, Zebra-Llama not only provides more accessible and reliable EDS information but also establishes a framework for developing specialized AI solutions for other rare conditions. This work represents a crucial step towards democratizing expert-level knowledge in rare disease management, potentially transforming how healthcare providers and patients navigate the complex landscape of rare diseases.

Guidance in conditional diffusion generation is of great importance for sample quality and controllability. However, existing guidance schemes are to be desired. On one hand, mainstream methods such as classifier guidance and classifier-free guidance both require extra training with labeled data, which is time-consuming and unable to adapt to new conditions. On the other hand, training-free methods such as universal guidance, though more flexible, have yet to demonstrate comparable performance. In this work, through a comprehensive investigation into the design space, we show that it is possible to achieve significant performance improvements over existing guidance schemes by leveraging off-the-shelf classifiers in a training-free fashion, enjoying the best of both worlds. Employing calibration as a general guideline, we propose several pre-conditioning techniques to better exploit pretrained off-the-shelf classifiers for guiding diffusion generation. Extensive experiments on ImageNet validate our proposed method, showing that state-of-the-art diffusion models (DDPM, EDM, DiT) can be further improved (up to 20%) using off-the-shelf classifiers with barely any extra computational cost. With the proliferation of publicly available pretrained classifiers, our proposed approach has great potential and can be readily scaled up to text-to-image generation tasks. The code is available at https://github.com/AlexMaOLS/EluCD/tree/main.

The field of medical diagnosis has undergone a significant transformation with the advent of large language models (LLMs), yet the challenges of interpretability within these models remain largely unaddressed. This study introduces Chain-of-Diagnosis (CoD) to enhance the interpretability of LLM-based medical diagnostics. CoD transforms the diagnostic process into a diagnostic chain that mirrors a physician's thought process, providing a transparent reasoning pathway. Additionally, CoD outputs the disease confidence distribution to ensure transparency in decision-making. This interpretability makes model diagnostics controllable and aids in identifying critical symptoms for inquiry through the entropy reduction of confidences. With CoD, we developed DiagnosisGPT, capable of diagnosing 9604 diseases. Experimental results demonstrate that DiagnosisGPT outperforms other LLMs on diagnostic benchmarks. Moreover, DiagnosisGPT provides interpretability while ensuring controllability in diagnostic rigor.

Generative models have reached an advanced stage where they can produce remarkably realistic images. However, this remarkable generative capability also introduces the risk of disseminating false or misleading information. Notably, existing image detectors for generated images encounter challenges such as low accuracy and limited generalization. This paper seeks to address this issue by seeking a representation with strong generalization capabilities to enhance the detection of generated images. Our investigation has revealed that real and generated images display distinct latent Gaussian representations when subjected to an inverse diffusion process within a pre-trained diffusion model. Exploiting this disparity, we can amplify subtle artifacts in generated images. Building upon this insight, we introduce a novel image representation known as Diffusion Noise Feature (DNF). DNF is extracted from the estimated noise generated during the inverse diffusion process. A simple classifier, e.g., ResNet50, trained on DNF achieves high accuracy, robustness, and generalization capabilities for detecting generated images (even the corresponding generator is built with datasets/structures that are not seen during the classifier's training). We conducted experiments using four training datasets and five testsets, achieving state-of-the-art detection performance.

Generating photos satisfying multiple constraints find broad utility in the content creation industry. A key hurdle to accomplishing this task is the need for paired data consisting of all modalities (i.e., constraints) and their corresponding output. Moreover, existing methods need retraining using paired data across all modalities to introduce a new condition. This paper proposes a solution to this problem based on denoising diffusion probabilistic models (DDPMs). Our motivation for choosing diffusion models over other generative models comes from the flexible internal structure of diffusion models. Since each sampling step in the DDPM follows a Gaussian distribution, we show that there exists a closed-form solution for generating an image given various constraints. Our method can unite multiple diffusion models trained on multiple sub-tasks and conquer the combined task through our proposed sampling strategy. We also introduce a novel reliability parameter that allows using different off-the-shelf diffusion models trained across various datasets during sampling time alone to guide it to the desired outcome satisfying multiple constraints. We perform experiments on various standard multimodal tasks to demonstrate the effectiveness of our approach. More details can be found in https://nithin-gk.github.io/projectpages/Multidiff/index.html

We introduce Efficient Motion Diffusion Model (EMDM) for fast and high-quality human motion generation. Current state-of-the-art generative diffusion models have produced impressive results but struggle to achieve fast generation without sacrificing quality. On the one hand, previous works, like motion latent diffusion, conduct diffusion within a latent space for efficiency, but learning such a latent space can be a non-trivial effort. On the other hand, accelerating generation by naively increasing the sampling step size, e.g., DDIM, often leads to quality degradation as it fails to approximate the complex denoising distribution. To address these issues, we propose EMDM, which captures the complex distribution during multiple sampling steps in the diffusion model, allowing for much fewer sampling steps and significant acceleration in generation. This is achieved by a conditional denoising diffusion GAN to capture multimodal data distributions among arbitrary (and potentially larger) step sizes conditioned on control signals, enabling fewer-step motion sampling with high fidelity and diversity. To minimize undesired motion artifacts, geometric losses are imposed during network learning. As a result, EMDM achieves real-time motion generation and significantly improves the efficiency of motion diffusion models compared to existing methods while achieving high-quality motion generation. Our code will be publicly available upon publication.

Magnetic resonance imaging (MRI) is a common and life-saving medical imaging technique. However, acquiring high signal-to-noise ratio MRI scans requires long scan times, resulting in increased costs and patient discomfort, and decreased throughput. Thus, there is great interest in denoising MRI scans, especially for the subtype of diffusion MRI scans that are severely SNR-limited. While most prior MRI denoising methods are supervised in nature, acquiring supervised training datasets for the multitude of anatomies, MRI scanners, and scan parameters proves impractical. Here, we propose Denoising Diffusion Models for Denoising Diffusion MRI (DDM^2), a self-supervised denoising method for MRI denoising using diffusion denoising generative models. Our three-stage framework integrates statistic-based denoising theory into diffusion models and performs denoising through conditional generation. During inference, we represent input noisy measurements as a sample from an intermediate posterior distribution within the diffusion Markov chain. We conduct experiments on 4 real-world in-vivo diffusion MRI datasets and show that our DDM^2 demonstrates superior denoising performances ascertained with clinically-relevant visual qualitative and quantitative metrics.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

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

Self-supervised learning (SSL) has potential for effective representation learning in medical imaging, but the choice of data augmentation is critical and domain-specific. It remains uncertain if general augmentation policies suit surgical applications. In this work, we automate the search for suitable augmentation policies through a new method called Dimensionality Driven Augmentation Search (DDA). DDA leverages the local dimensionality of deep representations as a proxy target, and differentiably searches for suitable data augmentation policies in contrastive learning. We demonstrate the effectiveness and efficiency of DDA in navigating a large search space and successfully identifying an appropriate data augmentation policy for laparoscopic surgery. We systematically evaluate DDA across three laparoscopic image classification and segmentation tasks, where it significantly improves over existing baselines. Furthermore, DDA's optimised set of augmentations provides insight into domain-specific dependencies when applying contrastive learning in medical applications. For example, while hue is an effective augmentation for natural images, it is not advantageous for laparoscopic images.

Common image-to-image translation methods rely on joint training over data from both source and target domains. The training process requires concurrent access to both datasets, which hinders data separation and privacy protection; and existing models cannot be easily adapted for translation of new domain pairs. We present Dual Diffusion Implicit Bridges (DDIBs), an image translation method based on diffusion models, that circumvents training on domain pairs. Image translation with DDIBs relies on two diffusion models trained independently on each domain, and is a two-step process: DDIBs first obtain latent encodings for source images with the source diffusion model, and then decode such encodings using the target model to construct target images. Both steps are defined via ordinary differential equations (ODEs), thus the process is cycle consistent only up to discretization errors of the ODE solvers. Theoretically, we interpret DDIBs as concatenation of source to latent, and latent to target Schrodinger Bridges, a form of entropy-regularized optimal transport, to explain the efficacy of the method. Experimentally, we apply DDIBs on synthetic and high-resolution image datasets, to demonstrate their utility in a wide variety of translation tasks and their inherent optimal transport properties.

Diffusion-based generative models have exhibited powerful generative performance in recent years. However, as many attributes exist in the data distribution and owing to several limitations of sharing the model parameters across all levels of the generation process, it remains challenging to control specific styles for each attribute. To address the above problem, this paper presents decoupled denoising diffusion models (DDDMs) with disentangled representations, which can control the style for each attribute in generative models. We apply DDDMs to voice conversion (VC) tasks to address the challenges of disentangling and controlling each speech attribute (e.g., linguistic information, intonation, and timbre). First, we use a self-supervised representation to disentangle the speech representation. Subsequently, the DDDMs are applied to resynthesize the speech from the disentangled representations for denoising with respect to each attribute. Moreover, we also propose the prior mixup for robust voice style transfer, which uses the converted representation of the mixed style as a prior distribution for the diffusion models. The experimental results reveal that our method outperforms publicly available VC models. Furthermore, we show that our method provides robust generative performance regardless of the model size. Audio samples are available https://hayeong0.github.io/DDDM-VC-demo/.

Advancements in DNA sequencing technologies have significantly improved our ability to decode genomic sequences. However, the prediction and interpretation of these sequences remain challenging due to the intricate nature of genetic material. Large language models (LLMs) have introduced new opportunities for biological sequence analysis. Recent developments in genomic language models have underscored the potential of LLMs in deciphering DNA sequences. Nonetheless, existing models often face limitations in robustness and application scope, primarily due to constraints in model structure and training data scale. To address these limitations, we present GENERator, a generative genomic foundation model featuring a context length of 98k base pairs (bp) and 1.2B parameters. Trained on an expansive dataset comprising 386B bp of eukaryotic DNA, the GENERator demonstrates state-of-the-art performance across both established and newly proposed benchmarks. The model adheres to the central dogma of molecular biology, accurately generating protein-coding sequences that translate into proteins structurally analogous to known families. It also shows significant promise in sequence optimization, particularly through the prompt-responsive generation of promoter sequences with specific activity profiles. These capabilities position the GENERator as a pivotal tool for genomic research and biotechnological advancement, enhancing our ability to interpret and predict complex biological systems and enabling precise genomic interventions.

Generative models, particularly text-to-image (T2I) diffusion models, play a crucial role in medical image analysis. However, these models are prone to training data memorization, posing significant risks to patient privacy. Synthetic chest X-ray generation is one of the most common applications in medical image analysis with the MIMIC-CXR dataset serving as the primary data repository for this task. This study adopts a data-driven approach and presents the first systematic attempt to identify prompts and text tokens in MIMIC-CXR that contribute the most to training data memorization. Our analysis reveals an unexpected finding: prompts containing traces of de-identification procedures are among the most memorized, with de-identification markers contributing the most. Furthermore, we also find existing inference-time memorization mitigation strategies are ineffective and fail to sufficiently reduce the model's reliance on memorized text tokens highlighting a broader issue in T2I synthesis with MIMIC-CXR. On this front, we propose actionable strategies to enhance privacy and improve the reliability of generative models in medical imaging. Finally, our results provide a foundation for future work on developing and benchmarking memorization mitigation techniques for synthetic chest X-ray generation using the MIMIC-CXR dataset.

After being collected for patient care, Observational Health Data (OHD) can further benefit patient well-being by sustaining the development of health informatics and medical research. Vast potential is unexploited because of the fiercely private nature of patient-related data and regulations to protect it. Generative Adversarial Networks (GANs) have recently emerged as a groundbreaking way to learn generative models that produce realistic synthetic data. They have revolutionized practices in multiple domains such as self-driving cars, fraud detection, digital twin simulations in industrial sectors, and medical imaging. The digital twin concept could readily apply to modelling and quantifying disease progression. In addition, GANs posses many capabilities relevant to common problems in healthcare: lack of data, class imbalance, rare diseases, and preserving privacy. Unlocking open access to privacy-preserving OHD could be transformative for scientific research. In the midst of COVID-19, the healthcare system is facing unprecedented challenges, many of which of are data related for the reasons stated above. Considering these facts, publications concerning GAN applied to OHD seemed to be severely lacking. To uncover the reasons for this slow adoption, we broadly reviewed the published literature on the subject. Our findings show that the properties of OHD were initially challenging for the existing GAN algorithms (unlike medical imaging, for which state-of-the-art model were directly transferable) and the evaluation synthetic data lacked clear metrics. We find more publications on the subject than expected, starting slowly in 2017, and since then at an increasing rate. The difficulties of OHD remain, and we discuss issues relating to evaluation, consistency, benchmarking, data modelling, and reproducibility.

Denoising diffusion (score-based) generative models have recently achieved significant accomplishments in generating realistic and diverse data. These approaches define a forward diffusion process for transforming data into noise and a backward denoising process for sampling data from noise. Unfortunately, the generation process of current denoising diffusion models is notoriously slow due to the lengthy iterative noise estimations, which rely on cumbersome neural networks. It prevents the diffusion models from being widely deployed, especially on edge devices. Previous works accelerate the generation process of diffusion model (DM) via finding shorter yet effective sampling trajectories. However, they overlook the cost of noise estimation with a heavy network in every iteration. In this work, we accelerate generation from the perspective of compressing the noise estimation network. Due to the difficulty of retraining DMs, we exclude mainstream training-aware compression paradigms and introduce post-training quantization (PTQ) into DM acceleration. However, the output distributions of noise estimation networks change with time-step, making previous PTQ methods fail in DMs since they are designed for single-time step scenarios. To devise a DM-specific PTQ method, we explore PTQ on DM in three aspects: quantized operations, calibration dataset, and calibration metric. We summarize and use several observations derived from all-inclusive investigations to formulate our method, which especially targets the unique multi-time-step structure of DMs. Experimentally, our method can directly quantize full-precision DMs into 8-bit models while maintaining or even improving their performance in a training-free manner. Importantly, our method can serve as a plug-and-play module on other fast-sampling methods, e.g., DDIM. The code is available at https://github.com/42Shawn/PTQ4DM .

Domain Generalization (DG) is a fundamental challenge for machine learning models, which aims to improve model generalization on various domains. Previous methods focus on generating domain invariant features from various source domains. However, we argue that the domain variantions also contain useful information, ie, classification-aware information, for downstream tasks, which has been largely ignored. Different from learning domain invariant features from source domains, we decouple the input images into Domain Expert Features and noise. The proposed domain expert features lie in a learned latent space where the images in each domain can be classified independently, enabling the implicit use of classification-aware domain variations. Based on the analysis, we proposed a novel paradigm called Domain Disentanglement Network (DDN) to disentangle the domain expert features from the source domain images and aggregate the source domain expert features for representing the target test domain. We also propound a new contrastive learning method to guide the domain expert features to form a more balanced and separable feature space. Experiments on the widely-used benchmarks of PACS, VLCS, OfficeHome, DomainNet, and TerraIncognita demonstrate the competitive performance of our method compared to the recently proposed alternatives.

Deep neural networks have been extensively applied in the medical domain for various tasks, including image classification, segmentation, and landmark detection. However, their application is often hindered by data scarcity, both in terms of available annotations and images. This study introduces a novel application of denoising diffusion probabilistic models (DDPMs) to the landmark detection task, specifically addressing the challenge of limited annotated data in x-ray imaging. Our key innovation lies in leveraging DDPMs for self-supervised pre-training in landmark detection, a previously unexplored approach in this domain. This method enables accurate landmark detection with minimal annotated training data (as few as 50 images), surpassing both ImageNet supervised pre-training and traditional self-supervised techniques across three popular x-ray benchmark datasets. To our knowledge, this work represents the first application of diffusion models for self-supervised learning in landmark detection, which may offer a valuable pre-training approach in few-shot regimes, for mitigating data scarcity.

The integration of Vector Quantised Variational AutoEncoder (VQ-VAE) with autoregressive models as generation part has yielded high-quality results on image generation. However, the autoregressive models will strictly follow the progressive scanning order during the sampling phase. This leads the existing VQ series models to hardly escape the trap of lacking global information. Denoising Diffusion Probabilistic Models (DDPM) in the continuous domain have shown a capability to capture the global context, while generating high-quality images. In the discrete state space, some works have demonstrated the potential to perform text generation and low resolution image generation. We show that with the help of a content-rich discrete visual codebook from VQ-VAE, the discrete diffusion model can also generate high fidelity images with global context, which compensates for the deficiency of the classical autoregressive model along pixel space. Meanwhile, the integration of the discrete VAE with the diffusion model resolves the drawback of conventional autoregressive models being oversized, and the diffusion model which demands excessive time in the sampling process when generating images. It is found that the quality of the generated images is heavily dependent on the discrete visual codebook. Extensive experiments demonstrate that the proposed Vector Quantised Discrete Diffusion Model (VQ-DDM) is able to achieve comparable performance to top-tier methods with low complexity. It also demonstrates outstanding advantages over other vectors quantised with autoregressive models in terms of image inpainting tasks without additional training.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

A code generation model generates code by taking a prompt from a code comment, existing code, or a combination of both. Although code generation models (e.g. GitHub Copilot) are increasingly being adopted in practice, it is unclear whether they can successfully be used for unit test generation without fine-tuning. We investigated how well three generative models (Codex, GPT-3.5-Turbo, and StarCoder) can generate test cases to fill this gap. We used two benchmarks (HumanEval and Evosuite SF110) to investigate the context generation's effect in the unit test generation process. We evaluated the models based on compilation rates, test correctness, coverage, and test smells. We found that the Codex model achieved above 80% coverage for the HumanEval dataset, but no model had more than 2% coverage for the EvoSuite SF110 benchmark. The generated tests also suffered from test smells, such as Duplicated Asserts and Empty Tests.

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

In machine learning, generative modeling aims to learn to generate new data statistically similar to the training data distribution. In this paper, we survey learning generative models under limited data, few shots and zero shot, referred to as Generative Modeling under Data Constraint (GM-DC). This is an important topic when data acquisition is challenging, e.g. healthcare applications. We discuss background, challenges, and propose two taxonomies: one on GM-DC tasks and another on GM-DC approaches. Importantly, we study interactions between different GM-DC tasks and approaches. Furthermore, we highlight research gaps, research trends, and potential avenues for future exploration. Project website: https://gmdc-survey.github.io.

Generative modeling of 3D LiDAR data is an emerging task with promising applications for autonomous mobile robots, such as scalable simulation, scene manipulation, and sparse-to-dense completion of LiDAR point clouds. While existing approaches have demonstrated the feasibility of image-based LiDAR data generation using deep generative models, they still struggle with fidelity and training stability. In this work, we present R2DM, a novel generative model for LiDAR data that can generate diverse and high-fidelity 3D scene point clouds based on the image representation of range and reflectance intensity. Our method is built upon denoising diffusion probabilistic models (DDPMs), which have shown impressive results among generative model frameworks in recent years. To effectively train DDPMs in the LiDAR domain, we first conduct an in-depth analysis of data representation, loss functions, and spatial inductive biases. Leveraging our R2DM model, we also introduce a flexible LiDAR completion pipeline based on the powerful capabilities of DDPMs. We demonstrate that our method surpasses existing methods in generating tasks on the KITTI-360 and KITTI-Raw datasets, as well as in the completion task on the KITTI-360 dataset. Our project page can be found at https://kazuto1011.github.io/r2dm.

Denoising diffusion probabilistic models (DDPMs) (Ho et al. 2020) have shown impressive results on image and waveform generation in continuous state spaces. Here, we introduce Discrete Denoising Diffusion Probabilistic Models (D3PMs), diffusion-like generative models for discrete data that generalize the multinomial diffusion model of Hoogeboom et al. 2021, by going beyond corruption processes with uniform transition probabilities. This includes corruption with transition matrices that mimic Gaussian kernels in continuous space, matrices based on nearest neighbors in embedding space, and matrices that introduce absorbing states. The third allows us to draw a connection between diffusion models and autoregressive and mask-based generative models. We show that the choice of transition matrix is an important design decision that leads to improved results in image and text domains. We also introduce a new loss function that combines the variational lower bound with an auxiliary cross entropy loss. For text, this model class achieves strong results on character-level text generation while scaling to large vocabularies on LM1B. On the image dataset CIFAR-10, our models approach the sample quality and exceed the log-likelihood of the continuous-space DDPM model.

Strategies for the generation of periodic discrete structures with identical two-point correlation are developed. Starting from a pair of root structures, which are not related by translation, phase inversion or axis reflections, child structures of arbitrary resolution (i.e., pixel or voxel numbers) and number of phases (i.e., material phases/species) can be generated by means of trivial embedding based phase extension, application of kernels and/or phase coalescence, such that the generated structures inherit the two-point-correlation equivalence. Proofs of the inheritance property are provided by means of the Discrete Fourier Transform theory. A Python 3 implementation of the results is offered by the authors through the Github repository https://github.com/DataAnalyticsEngineering/EQ2PC in order to make the provided results reproducible and useful for all interested readers. Examples for the generation of structures are demonstrated, together with applications in the homogenization theory of periodic media.

Social determinants of health (SDoH) have an important impact on patient outcomes but are incompletely collected from the electronic health records (EHR). This study researched the ability of large language models to extract SDoH from free text in EHRs, where they are most commonly documented, and explored the role of synthetic clinical text for improving the extraction of these scarcely documented, yet extremely valuable, clinical data. 800 patient notes were annotated for SDoH categories, and several transformer-based models were evaluated. The study also experimented with synthetic data generation and assessed for algorithmic bias. Our best-performing models were fine-tuned Flan-T5 XL (macro-F1 0.71) for any SDoH, and Flan-T5 XXL (macro-F1 0.70). The benefit of augmenting fine-tuning with synthetic data varied across model architecture and size, with smaller Flan-T5 models (base and large) showing the greatest improvements in performance (delta F1 +0.12 to +0.23). Model performance was similar on the in-hospital system dataset but worse on the MIMIC-III dataset. Our best-performing fine-tuned models outperformed zero- and few-shot performance of ChatGPT-family models for both tasks. These fine-tuned models were less likely than ChatGPT to change their prediction when race/ethnicity and gender descriptors were added to the text, suggesting less algorithmic bias (p<0.05). At the patient-level, our models identified 93.8% of patients with adverse SDoH, while ICD-10 codes captured 2.0%. Our method can effectively extracted SDoH information from clinic notes, performing better compare to GPT zero- and few-shot settings. These models could enhance real-world evidence on SDoH and aid in identifying patients needing social support.

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

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

The integration of Computer-Assisted Diagnosis (CAD) with Large Language Models (LLMs) holds great potential in clinical applications, specifically in the roles of virtual family doctors and clinic assistants. However, current works in this field are plagued by limitations, specifically a restricted scope of applicable image domains and the provision of unreliable medical advice. This restricts their overall processing capabilities. Furthermore, the mismatch in writing style between LLMs and radiologists undermines their practical usefulness. To tackle these challenges, we introduce ChatCAD+, which is designed to be universal and reliable. It is capable of handling medical images from diverse domains and leveraging up-to-date information from reputable medical websites to provide reliable medical advice. Additionally, it incorporates a template retrieval system that improves report generation performance via exemplar reports. This approach ensures greater consistency with the expertise of human professionals. The source code is available at https://github.com/zhaozh10/ChatCAD.

Denoising diffusion models (DDMs) have recently attracted increasing attention by showing impressive synthesis quality. DDMs are built on a diffusion process that pushes data to the noise distribution and the models learn to denoise. In this paper, we establish the interpretation of DDMs in terms of image restoration (IR). Integrating IR literature allows us to use an alternative objective and diverse forward processes, not confining to the diffusion process. By imposing prior knowledge on the loss function grounded on MAP-based estimation, we eliminate the need for the expensive sampling of DDMs. Also, we propose a multi-scale training, which improves the performance compared to the diffusion process, by taking advantage of the flexibility of the forward process. Experimental results demonstrate that our model improves the quality and efficiency of both training and inference. Furthermore, we show the applicability of our model to inverse problems. We believe that our framework paves the way for designing a new type of flexible general generative model.

Recently, Computer-Aided Diagnosis (CAD) systems have emerged as indispensable tools in clinical diagnostic workflows, significantly alleviating the burden on radiologists. Nevertheless, despite their integration into clinical settings, CAD systems encounter limitations. Specifically, while CAD systems can achieve high performance in the detection of lung nodules, they face challenges in accurately predicting multiple cancer types. This limitation can be attributed to the scarcity of publicly available datasets annotated with expert-level cancer type information. This research aims to bridge this gap by providing publicly accessible datasets and reliable tools for medical diagnosis, facilitating a finer categorization of different types of lung diseases so as to offer precise treatment recommendations. To achieve this objective, we curated a diverse dataset of lung Computed Tomography (CT) images, comprising 330 annotated nodules (nodules are labeled as bounding boxes) from 95 distinct patients. The quality of the dataset was evaluated using a variety of classical classification and detection models, and these promising results demonstrate that the dataset has a feasible application and further facilitate intelligent auxiliary diagnosis.

Denoising Diffusion Probabilistic Models (DDPMs) exhibit remarkable capabilities in image generation, with studies suggesting that they can generalize by composing latent factors learned from the training data. In this work, we go further and study DDPMs trained on strictly separate subsets of the data distribution with large gaps on the support of the latent factors. We show that such a model can effectively generate images in the unexplored, intermediate regions of the distribution. For instance, when trained on clearly smiling and non-smiling faces, we demonstrate a sampling procedure which can generate slightly smiling faces without reference images (zero-shot interpolation). We replicate these findings for other attributes as well as other datasets. Our code is available at https://github.com/jdeschena/ddpm-zero-shot-interpolation.

Over the last five years, deep generative models have gradually been adopted for various tasks in biological research. Notably, image-to-image translation methods showed to be effective in revealing subtle phenotypic cell variations otherwise invisible to the human eye. Current methods to achieve this goal mainly rely on Generative Adversarial Networks (GANs). However, these models are known to suffer from some shortcomings such as training instability and mode collapse. Furthermore, the lack of robustness to invert a real image into the latent of a trained GAN prevents flexible editing of real images. In this work, we propose PhenDiff, an image-to-image translation method based on conditional diffusion models to identify subtle phenotypes in microscopy images. We evaluate this approach on biological datasets against previous work such as CycleGAN. We show that PhenDiff outperforms this baseline in terms of quality and diversity of the generated images. We then apply this method to display invisible phenotypic changes triggered by a rare neurodevelopmental disorder on microscopy images of organoids. Altogether, we demonstrate that PhenDiff is able to perform high quality biological image-to-image translation allowing to spot subtle phenotype variations on a real image.

Social and behavioral determinants of health (SBDH) play a crucial role in health outcomes and are frequently documented in clinical text. Automatically extracting SBDH information from clinical text relies on publicly available good-quality datasets. However, existing SBDH datasets exhibit substantial limitations in their availability and coverage. In this study, we introduce Synth-SBDH, a novel synthetic dataset with detailed SBDH annotations, encompassing status, temporal information, and rationale across 15 SBDH categories. We showcase the utility of Synth-SBDH on three tasks using real-world clinical datasets from two distinct hospital settings, highlighting its versatility, generalizability, and distillation capabilities. Models trained on Synth-SBDH consistently outperform counterparts with no Synth-SBDH training, achieving up to 62.5% macro-F improvements. Additionally, Synth-SBDH proves effective for rare SBDH categories and under-resource constraints. Human evaluation demonstrates a Human-LLM alignment of 71.06% and uncovers areas for future refinements.

Recently, various methods have been proposed to address the inconsistency issue of DDIM inversion to enable image editing, such as EDICT [36] and Null-text inversion [22]. However, the above methods introduce considerable computational overhead. In this paper, we propose a new technique, named bi-directional integration approximation (BDIA), to perform exact diffusion inversion with neglible computational overhead. Suppose we would like to estimate the next diffusion state z_{i-1} at timestep t_i with the historical information (i,z_i) and (i+1,z_{i+1}). We first obtain the estimated Gaussian noise boldsymbol{epsilon}(z_i,i), and then apply the DDIM update procedure twice for approximating the ODE integration over the next time-slot [t_i, t_{i-1}] in the forward manner and the previous time-slot [t_i, t_{t+1}] in the backward manner. The DDIM step for the previous time-slot is used to refine the integration approximation made earlier when computing z_i. A nice property of BDIA-DDIM is that the update expression for z_{i-1} is a linear combination of (z_{i+1}, z_i, boldsymbol{epsilon}(z_i,i)). This allows for exact backward computation of z_{i+1} given (z_i, z_{i-1}), thus leading to exact diffusion inversion. It is demonstrated with experiments that (round-trip) BDIA-DDIM is particularly effective for image editing. Our experiments further show that BDIA-DDIM produces markedly better image sampling qualities than DDIM for text-to-image generation. BDIA can also be applied to improve the performance of other ODE solvers in addition to DDIM. In our work, it is found that applying BDIA to the EDM sampling procedure produces consistently better performance over four pre-trained models.

Diffusion probabilistic models have been shown to generate state-of-the-art results on several competitive image synthesis benchmarks but lack a low-dimensional, interpretable latent space, and are slow at generation. On the other hand, standard Variational Autoencoders (VAEs) typically have access to a low-dimensional latent space but exhibit poor sample quality. We present DiffuseVAE, a novel generative framework that integrates VAE within a diffusion model framework, and leverage this to design novel conditional parameterizations for diffusion models. We show that the resulting model equips diffusion models with a low-dimensional VAE inferred latent code which can be used for downstream tasks like controllable synthesis. The proposed method also improves upon the speed vs quality tradeoff exhibited in standard unconditional DDPM/DDIM models (for instance, FID of 16.47 vs 34.36 using a standard DDIM on the CelebA-HQ-128 benchmark using T=10 reverse process steps) without having explicitly trained for such an objective. Furthermore, the proposed model exhibits synthesis quality comparable to state-of-the-art models on standard image synthesis benchmarks like CIFAR-10 and CelebA-64 while outperforming most existing VAE-based methods. Lastly, we show that the proposed method exhibits inherent generalization to different types of noise in the conditioning signal. For reproducibility, our source code is publicly available at https://github.com/kpandey008/DiffuseVAE.

Since the COVID-19 pandemic, clinicians have seen a large and sustained influx in patient portal messages, significantly contributing to clinician burnout. To the best of our knowledge, there are no large-scale public patient portal messages corpora researchers can use to build tools to optimize clinician portal workflows. Informed by our ongoing work with a regional hospital, this study introduces an LLM-powered framework for configurable and realistic patient portal message generation. Our approach leverages few-shot grounded text generation, requiring only a small number of de-identified patient portal messages to help LLMs better match the true style and tone of real data. Clinical experts in our team deem this framework as HIPAA-friendly, unlike existing privacy-preserving approaches to synthetic text generation which cannot guarantee all sensitive attributes will be protected. Through extensive quantitative and human evaluation, we show that our framework produces data of higher quality than comparable generation methods as well as all related datasets. We believe this work provides a path forward for (i) the release of large-scale synthetic patient message datasets that are stylistically similar to ground-truth samples and (ii) HIPAA-friendly data generation which requires minimal human de-identification efforts.

Synthetic data generation has the potential to impact applications and domains with scarce data. However, before such data is used for sensitive tasks such as mental health, we need an understanding of how different demographics are represented in it. In our paper, we analyze the potential of producing synthetic data using GPT-3 by exploring the various stressors it attributes to different race and gender combinations, to provide insight for future researchers looking into using LLMs for data generation. Using GPT-3, we develop HEADROOM, a synthetic dataset of 3,120 posts about depression-triggering stressors, by controlling for race, gender, and time frame (before and after COVID-19). Using this dataset, we conduct semantic and lexical analyses to (1) identify the predominant stressors for each demographic group; and (2) compare our synthetic data to a human-generated dataset. We present the procedures to generate queries to develop depression data using GPT-3, and conduct analyzes to uncover the types of stressors it assigns to demographic groups, which could be used to test the limitations of LLMs for synthetic data generation for depression data. Our findings show that synthetic data mimics some of the human-generated data distribution for the predominant depression stressors across diverse demographics.

Unit tests (UTs) play an instrumental role in assessing code correctness as well as providing feedback to a large language model (LLM) as it iteratively debugs faulty code, motivating automated test generation. However, we uncover a trade-off between generating unit test inputs that reveal errors when given a faulty code and correctly predicting the unit test output without access to the gold solution. To address this trade-off, we propose UTGen, which teaches LLMs to generate unit test inputs that reveal errors along with their correct expected outputs based on task descriptions and candidate code. We integrate UTGen into UTDebug, a robust debugging pipeline that uses generated tests to help LLMs debug effectively. Since model-generated tests can provide noisy signals (e.g., from incorrectly predicted outputs), UTDebug (i) scales UTGen via test-time compute to improve UT output prediction, and (ii) validates and back-tracks edits based on multiple generated UTs to avoid overfitting. We show that UTGen outperforms UT generation baselines by 7.59% based on a metric measuring the presence of both error-revealing UT inputs and correct UT outputs. When used with UTDebug, we find that feedback from UTGen's unit tests improves pass@1 accuracy of Qwen-2.5 7B on HumanEvalFix and our own harder debugging split of MBPP+ by over 3% and 12.35% (respectively) over other LLM-based UT generation baselines.

Recent inverse problem solvers that leverage generative diffusion priors have garnered significant attention due to their exceptional quality. However, adaptation of the prior is necessary when there exists a discrepancy between the training and testing distributions. In this work, we propose deep diffusion image prior (DDIP), which generalizes the recent adaptation method of SCD by introducing a formal connection to the deep image prior. Under this framework, we propose an efficient adaptation method dubbed D3IP, specified for 3D measurements, which accelerates DDIP by orders of magnitude while achieving superior performance. D3IP enables seamless integration of 3D inverse solvers and thus leads to coherent 3D reconstruction. Moreover, we show that meta-learning techniques can also be applied to yield even better performance. We show that our method is capable of solving diverse 3D reconstructive tasks from the generative prior trained only with phantom images that are vastly different from the training set, opening up new opportunities of applying diffusion inverse solvers even when training with gold standard data is impossible. Code: https://github.com/HJ-harry/DDIP3D

During their formative years, radiology trainees are required to interpret hundreds of mammograms per month, with the objective of becoming apt at discerning the subtle patterns differentiating benign from malignant lesions. Unfortunately, medico-legal and technical hurdles make it difficult to access and query medical images for training. In this paper we train a generative adversarial network (GAN) to synthesize 512 x 512 high-resolution mammograms. The resulting model leads to the unsupervised separation of high-level features (e.g. the standard mammography views and the nature of the breast lesions), with stochastic variation in the generated images (e.g. breast adipose tissue, calcification), enabling user-controlled global and local attribute-editing of the synthesized images. We demonstrate the model's ability to generate anatomically and medically relevant mammograms by achieving an average AUC of 0.54 in a double-blind study on four expert mammography radiologists to distinguish between generated and real images, ascribing to the high visual quality of the synthesized and edited mammograms, and to their potential use in advancing and facilitating medical education.

In recent years, the advent of foundation models (FM) for digital pathology has relied heavily on scaling the pre-training datasets and the model size, yielding large and powerful models. While it resulted in improving the performance on diverse downstream tasks, it also introduced increased computational cost and inference time. In this work, we explore the distillation of a large foundation model into a smaller one, reducing the number of parameters by several orders of magnitude. Leveraging distillation techniques, our distilled model, H0-mini, achieves nearly comparable performance to large FMs at a significantly reduced inference cost. It is evaluated on several public benchmarks, achieving 3rd place on the HEST benchmark and 5th place on the EVA benchmark. Additionally, a robustness analysis conducted on the PLISM dataset demonstrates that our distilled model reaches excellent robustness to variations in staining and scanning conditions, significantly outperforming other state-of-the art models. This opens new perspectives to design lightweight and robust models for digital pathology, without compromising on performance.

Anonymized data is highly valuable to both businesses and researchers. A large body of research has however shown the strong limits of the de-identification release-and-forget model, where data is anonymized and shared. This has led to the development of privacy-preserving query-based systems. Based on the idea of "sticky noise", Diffix has been recently proposed as a novel query-based mechanism satisfying alone the EU Article~29 Working Party's definition of anonymization. According to its authors, Diffix adds less noise to answers than solutions based on differential privacy while allowing for an unlimited number of queries. This paper presents a new class of noise-exploitation attacks, exploiting the noise added by the system to infer private information about individuals in the dataset. Our first differential attack uses samples extracted from Diffix in a likelihood ratio test to discriminate between two probability distributions. We show that using this attack against a synthetic best-case dataset allows us to infer private information with 89.4% accuracy using only 5 attributes. Our second cloning attack uses dummy conditions that conditionally strongly affect the output of the query depending on the value of the private attribute. Using this attack on four real-world datasets, we show that we can infer private attributes of at least 93% of the users in the dataset with accuracy between 93.3% and 97.1%, issuing a median of 304 queries per user. We show how to optimize this attack, targeting 55.4% of the users and achieving 91.7% accuracy, using a maximum of only 32 queries per user. Our attacks demonstrate that adding data-dependent noise, as done by Diffix, is not sufficient to prevent inference of private attributes. We furthermore argue that Diffix alone fails to satisfy Art. 29 WP's definition of anonymization. [...]

Machine learning models in health care are often deployed in settings where it is important to protect patient privacy. In such settings, methods for differentially private (DP) learning provide a general-purpose approach to learn models with privacy guarantees. Modern methods for DP learning ensure privacy through mechanisms that censor information judged as too unique. The resulting privacy-preserving models, therefore, neglect information from the tails of a data distribution, resulting in a loss of accuracy that can disproportionately affect small groups. In this paper, we study the effects of DP learning in health care. We use state-of-the-art methods for DP learning to train privacy-preserving models in clinical prediction tasks, including x-ray classification of images and mortality prediction in time series data. We use these models to perform a comprehensive empirical investigation of the tradeoffs between privacy, utility, robustness to dataset shift, and fairness. Our results highlight lesser-known limitations of methods for DP learning in health care, models that exhibit steep tradeoffs between privacy and utility, and models whose predictions are disproportionately influenced by large demographic groups in the training data. We discuss the costs and benefits of differentially private learning in health care.

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

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

Finding an initial noise vector that produces an input image when fed into the diffusion process (known as inversion) is an important problem in denoising diffusion models (DDMs), with applications for real image editing. The state-of-the-art approach for real image editing with inversion uses denoising diffusion implicit models (DDIMs) to deterministically noise the image to the intermediate state along the path that the denoising would follow given the original conditioning. However, DDIM inversion for real images is unstable as it relies on local linearization assumptions, which result in the propagation of errors, leading to incorrect image reconstruction and loss of content. To alleviate these problems, we propose Exact Diffusion Inversion via Coupled Transformations (EDICT), an inversion method that draws inspiration from affine coupling layers. EDICT enables mathematically exact inversion of real and model-generated images by maintaining two coupled noise vectors which are used to invert each other in an alternating fashion. Using Stable Diffusion, a state-of-the-art latent diffusion model, we demonstrate that EDICT successfully reconstructs real images with high fidelity. On complex image datasets like MS-COCO, EDICT reconstruction significantly outperforms DDIM, improving the mean square error of reconstruction by a factor of two. Using noise vectors inverted from real images, EDICT enables a wide range of image edits--from local and global semantic edits to image stylization--while maintaining fidelity to the original image structure. EDICT requires no model training/finetuning, prompt tuning, or extra data and can be combined with any pretrained DDM. Code is available at https://github.com/salesforce/EDICT.

Language model detoxification aims to minimize the risk of generating offensive or harmful content in pretrained language models (PLMs) for safer deployment. Existing methods can be roughly categorized as finetuning-based and decoding-based. However, the former is often resource-intensive, while the latter relies on additional components and potentially compromises the generation fluency. In this paper, we propose a more lightweight approach that enables the PLM itself to achieve "self-detoxification". Our method is built upon the observation that prepending a negative steering prompt can effectively induce PLMs to generate toxic content. At the same time, we are inspired by the recent research in the interpretability field, which formulates the evolving contextualized representations within the PLM as an information stream facilitated by the attention layers. Drawing on this idea, we devise a method to identify the toxification direction from the normal generation process to the one prompted with the negative prefix, and then steer the generation to the reversed direction by manipulating the information movement within the attention layers. Experimental results show that our approach, without any fine-tuning or extra components, can achieve comparable performance with state-of-the-art methods.

Score-based diffusion models, while achieving remarkable empirical performance, often suffer from low sampling speed, due to extensive function evaluations needed during the sampling phase. Despite a flurry of recent activities towards speeding up diffusion generative modeling in practice, theoretical underpinnings for acceleration techniques remain severely limited. In this paper, we design novel training-free algorithms to accelerate popular deterministic (i.e., DDIM) and stochastic (i.e., DDPM) samplers. Our accelerated deterministic sampler converges at a rate O(1/{T}^2) with T the number of steps, improving upon the O(1/T) rate for the DDIM sampler; and our accelerated stochastic sampler converges at a rate O(1/T), outperforming the rate O(1/T) for the DDPM sampler. The design of our algorithms leverages insights from higher-order approximation, and shares similar intuitions as popular high-order ODE solvers like the DPM-Solver-2. Our theory accommodates ell_2-accurate score estimates, and does not require log-concavity or smoothness on the target distribution.

An ugly duckling is an obviously different skin lesion from surrounding lesions of an individual, and the ugly duckling sign is a criterion used to aid in the diagnosis of cutaneous melanoma by differentiating between highly suspicious and benign lesions. However, the appearance of pigmented lesions, can change drastically from one patient to another, resulting in difficulties in visual separation of ugly ducklings. Hence, we propose DMT-Quadruplet - a deep metric learning network to learn lesion features at two tiers - patient-level and lesion-level. We introduce a patient-specific quadruplet mining approach together with a tiered quadruplet network, to drive the network to learn more contextual information both globally and locally between the two tiers. We further incorporate a dynamic margin within the patient-specific mining to allow more useful quadruplets to be mined within individuals. Comprehensive experiments show that our proposed method outperforms traditional classifiers, achieving 54% higher sensitivity than a baseline ResNet18 CNN and 37% higher than a naive triplet network in classifying ugly duckling lesions. Visualisation of the data manifold in the metric space further illustrates that DMT-Quadruplet is capable of classifying ugly duckling lesions in both patient-specific and patient-agnostic manner successfully.

Diffusion model-based inverse problem solvers have shown impressive performance, but are limited in speed, mostly as they require reverse diffusion sampling starting from noise. Several recent works have tried to alleviate this problem by building a diffusion process, directly bridging the clean and the corrupted for specific inverse problems. In this paper, we first unify these existing works under the name Direct Diffusion Bridges (DDB), showing that while motivated by different theories, the resulting algorithms only differ in the choice of parameters. Then, we highlight a critical limitation of the current DDB framework, namely that it does not ensure data consistency. To address this problem, we propose a modified inference procedure that imposes data consistency without the need for fine-tuning. We term the resulting method data Consistent DDB (CDDB), which outperforms its inconsistent counterpart in terms of both perception and distortion metrics, thereby effectively pushing the Pareto-frontier toward the optimum. Our proposed method achieves state-of-the-art results on both evaluation criteria, showcasing its superiority over existing methods.

Advances in natural language processing techniques, such as named entity recognition and normalization to widely used standardized terminologies like UMLS or SNOMED-CT, along with the digitalization of electronic health records, have significantly advanced clinical text analysis. This study presents ClinLinker, a novel approach employing a two-phase pipeline for medical entity linking that leverages the potential of in-domain adapted language models for biomedical text mining: initial candidate retrieval using a SapBERT-based bi-encoder and subsequent re-ranking with a cross-encoder, trained by following a contrastive-learning strategy to be tailored to medical concepts in Spanish. This methodology, focused initially on content in Spanish, substantially outperforming multilingual language models designed for the same purpose. This is true even for complex scenarios involving heterogeneous medical terminologies and being trained on a subset of the original data. Our results, evaluated using top-k accuracy at 25 and other top-k metrics, demonstrate our approach's performance on two distinct clinical entity linking Gold Standard corpora, DisTEMIST (diseases) and MedProcNER (clinical procedures), outperforming previous benchmarks by 40 points in DisTEMIST and 43 points in MedProcNER, both normalized to SNOMED-CT codes. These findings highlight our approach's ability to address language-specific nuances and set a new benchmark in entity linking, offering a potent tool for enhancing the utility of digital medical records. The resulting system is of practical value, both for large scale automatic generation of structured data derived from clinical records, as well as for exhaustive extraction and harmonization of predefined clinical variables of interest.

Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.

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

The conjoining of dynamical systems and deep learning has become a topic of great interest. In particular, neural differential equations (NDEs) demonstrate that neural networks and differential equation are two sides of the same coin. Traditional parameterised differential equations are a special case. Many popular neural network architectures, such as residual networks and recurrent networks, are discretisations. NDEs are suitable for tackling generative problems, dynamical systems, and time series (particularly in physics, finance, ...) and are thus of interest to both modern machine learning and traditional mathematical modelling. NDEs offer high-capacity function approximation, strong priors on model space, the ability to handle irregular data, memory efficiency, and a wealth of available theory on both sides. This doctoral thesis provides an in-depth survey of the field. Topics include: neural ordinary differential equations (e.g. for hybrid neural/mechanistic modelling of physical systems); neural controlled differential equations (e.g. for learning functions of irregular time series); and neural stochastic differential equations (e.g. to produce generative models capable of representing complex stochastic dynamics, or sampling from complex high-dimensional distributions). Further topics include: numerical methods for NDEs (e.g. reversible differential equations solvers, backpropagation through differential equations, Brownian reconstruction); symbolic regression for dynamical systems (e.g. via regularised evolution); and deep implicit models (e.g. deep equilibrium models, differentiable optimisation). We anticipate this thesis will be of interest to anyone interested in the marriage of deep learning with dynamical systems, and hope it will provide a useful reference for the current state of the art.

Due to the three-dimensional nature of CT- or MR-scans, generative modeling of medical images is a particularly challenging task. Existing approaches mostly apply patch-wise, slice-wise, or cascaded generation techniques to fit the high-dimensional data into the limited GPU memory. However, these approaches may introduce artifacts and potentially restrict the model's applicability for certain downstream tasks. This work presents WDM, a wavelet-based medical image synthesis framework that applies a diffusion model on wavelet decomposed images. The presented approach is a simple yet effective way of scaling diffusion models to high resolutions and can be trained on a single 40 GB GPU. Experimental results on BraTS and LIDC-IDRI unconditional image generation at a resolution of 128 times 128 times 128 show state-of-the-art image fidelity (FID) and sample diversity (MS-SSIM) scores compared to GANs, Diffusion Models, and Latent Diffusion Models. Our proposed method is the only one capable of generating high-quality images at a resolution of 256 times 256 times 256.

Real-world data can be multimodal distributed, e.g., data describing the opinion divergence in a community, the interspike interval distribution of neurons, and the oscillators natural frequencies. Generating multimodal distributed real-world data has become a challenge to existing generative adversarial networks (GANs). For example, neural stochastic differential equations (Neural SDEs), treated as infinite-dimensional GANs, have demonstrated successful performance mainly in generating unimodal time series data. In this paper, we propose a novel time series generator, named directed chain GANs (DC-GANs), which inserts a time series dataset (called a neighborhood process of the directed chain or input) into the drift and diffusion coefficients of the directed chain SDEs with distributional constraints. DC-GANs can generate new time series of the same distribution as the neighborhood process, and the neighborhood process will provide the key step in learning and generating multimodal distributed time series. The proposed DC-GANs are examined on four datasets, including two stochastic models from social sciences and computational neuroscience, and two real-world datasets on stock prices and energy consumption. To our best knowledge, DC-GANs are the first work that can generate multimodal time series data and consistently outperforms state-of-the-art benchmarks with respect to measures of distribution, data similarity, and predictive ability.

A data-driven model (DDM) suitable for regional weather forecasting applications is presented. The model extends the Artificial Intelligence Forecasting System by introducing a stretched-grid architecture that dedicates higher resolution over a regional area of interest and maintains a lower resolution elsewhere on the globe. The model is based on graph neural networks, which naturally affords arbitrary multi-resolution grid configurations. The model is applied to short-range weather prediction for the Nordics, producing forecasts at 2.5 km spatial and 6 h temporal resolution. The model is pre-trained on 43 years of global ERA5 data at 31 km resolution and is further refined using 3.3 years of 2.5 km resolution operational analyses from the MetCoOp Ensemble Prediction System (MEPS). The performance of the model is evaluated using surface observations from measurement stations across Norway and is compared to short-range weather forecasts from MEPS. The DDM outperforms both the control run and the ensemble mean of MEPS for 2 m temperature. The model also produces competitive precipitation and wind speed forecasts, but is shown to underestimate extreme events.

User-generated data sources have gained significance in uncovering Adverse Drug Reactions (ADRs), with an increasing number of discussions occurring in the digital world. However, the existing clinical corpora predominantly revolve around scientific articles in English. This work presents a multilingual corpus of texts concerning ADRs gathered from diverse sources, including patient fora, social media, and clinical reports in German, French, and Japanese. Our corpus contains annotations covering 12 entity types, four attribute types, and 13 relation types. It contributes to the development of real-world multilingual language models for healthcare. We provide statistics to highlight certain challenges associated with the corpus and conduct preliminary experiments resulting in strong baselines for extracting entities and relations between these entities, both within and across languages.

The recent introduction of synthetic correlated diffusion (CDI^s) imaging has demonstrated significant potential in the realm of clinical decision support for prostate cancer (PCa). CDI^s is a new form of magnetic resonance imaging (MRI) designed to characterize tissue characteristics through the joint correlation of diffusion signal attenuation across different Brownian motion sensitivities. Despite the performance improvement, the CDI^s data for PCa has not been previously made publicly available. In our commitment to advance research efforts for PCa, we introduce Cancer-Net PCa-Data, an open-source benchmark dataset of volumetric CDI^s imaging data of PCa patients. Cancer-Net PCa-Data consists of CDI^s volumetric images from a patient cohort of 200 patient cases, along with full annotations (gland masks, tumor masks, and PCa diagnosis for each tumor). We also analyze the demographic and label region diversity of Cancer-Net PCa-Data for potential biases. Cancer-Net PCa-Data is the first-ever public dataset of CDI^s imaging data for PCa, and is a part of the global open-source initiative dedicated to advancement in machine learning and imaging research to aid clinicians in the global fight against cancer.

Colorectal Cancer(CRC) poses a great risk to public health. It is the third most common cause of cancer in the US. Development of colorectal polyps is one of the earliest signs of cancer. Early detection and resection of polyps can greatly increase survival rate to 90%. Manual inspection can cause misdetections because polyps vary in color, shape, size and appearance. To this end, Computer-Aided Diagnosis systems(CADx) has been proposed that detect polyps by processing the colonoscopic videos. The system acts a secondary check to help clinicians reduce misdetections so that polyps may be resected before they transform to cancer. Polyps vary in color, shape, size, texture and appearance. As a result, the miss rate of polyps is between 6% and 27% despite the prominence of CADx solutions. Furthermore, sessile and flat polyps which have diameter less than 10 mm are more likely to be undetected. Convolutional Neural Networks(CNN) have shown promising results in polyp segmentation. However, all of these works have a supervised approach and are limited by the size of the dataset. It was observed that smaller datasets reduce the segmentation accuracy of ResUNet++. We train a U-Net to inpaint randomly dropped out pixels in the image as a proxy task. The dataset we use for pre-training is Kvasir-SEG dataset. This is followed by a supervised training on the limited Kvasir-Sessile dataset. Our experimental results demonstrate that with limited annotated dataset and a larger unlabeled dataset, self-supervised approach is a better alternative than fully supervised approach. Specifically, our self-supervised U-Net performs better than five segmentation models which were trained in supervised manner on the Kvasir-Sessile dataset.

Diffusion models (DMs) have revolutionized generative learning. They utilize a diffusion process to encode data into a simple Gaussian distribution. However, encoding a complex, potentially multimodal data distribution into a single continuous Gaussian distribution arguably represents an unnecessarily challenging learning problem. We propose Discrete-Continuous Latent Variable Diffusion Models (DisCo-Diff) to simplify this task by introducing complementary discrete latent variables. We augment DMs with learnable discrete latents, inferred with an encoder, and train DM and encoder end-to-end. DisCo-Diff does not rely on pre-trained networks, making the framework universally applicable. The discrete latents significantly simplify learning the DM's complex noise-to-data mapping by reducing the curvature of the DM's generative ODE. An additional autoregressive transformer models the distribution of the discrete latents, a simple step because DisCo-Diff requires only few discrete variables with small codebooks. We validate DisCo-Diff on toy data, several image synthesis tasks as well as molecular docking, and find that introducing discrete latents consistently improves model performance. For example, DisCo-Diff achieves state-of-the-art FID scores on class-conditioned ImageNet-64/128 datasets with ODE sampler.

Recently proposed large-scale text-to-image generative models such as DALLcdotE 2, Midjourney, and StableDiffusion can generate high-quality and realistic images from users' prompts. Not limited to the research community, ordinary Internet users enjoy these generative models, and consequently, a tremendous amount of generated images have been shared on the Internet. Meanwhile, today's success of deep learning in the computer vision field owes a lot to images collected from the Internet. These trends lead us to a research question: "will such generated images impact the quality of future datasets and the performance of computer vision models positively or negatively?" This paper empirically answers this question by simulating contamination. Namely, we generate ImageNet-scale and COCO-scale datasets using a state-of-the-art generative model and evaluate models trained with "contaminated" datasets on various tasks, including image classification and image generation. Throughout experiments, we conclude that generated images negatively affect downstream performance, while the significance depends on tasks and the amount of generated images. The generated datasets and the codes for experiments will be publicly released for future research. Generated datasets and source codes are available from https://github.com/moskomule/dataset-contamination.

A popular approach to sample a diffusion-based generative model is to solve an ordinary differential equation (ODE). In existing samplers, the coefficients of the ODE solvers are pre-determined by the ODE formulation, the reverse discrete timesteps, and the employed ODE methods. In this paper, we consider accelerating several popular ODE-based sampling processes (including EDM, DDIM, and DPM-Solver) by optimizing certain coefficients via improved integration approximation (IIA). We propose to minimize, for each time step, a mean squared error (MSE) function with respect to the selected coefficients. The MSE is constructed by applying the original ODE solver for a set of fine-grained timesteps, which in principle provides a more accurate integration approximation in predicting the next diffusion state. The proposed IIA technique does not require any change of a pre-trained model, and only introduces a very small computational overhead for solving a number of quadratic optimization problems. Extensive experiments show that considerably better FID scores can be achieved by using IIA-EDM, IIA-DDIM, and IIA-DPM-Solver than the original counterparts when the neural function evaluation (NFE) is small (i.e., less than 25).