arXiv subjects

Zhuangzhi Gao

Publications and source records attributed to Zhuangzhi Gao.

10 recordsLinked to original sources

arXiv2026

Teaching PPG How not Who: Fixed-Effects Distillation from ECG

ECG is widely used to teach PPG-only models, yet what it teaches is unexamined. Wearables are valued for tracking how a person's cardiovascular state changes, but ECG-to-PPG distillation mostly learns who the person is. A per-recording mean, the trait, holds 40-59% of a frozen ECG teacher's target, and pooled students memorise it without carrying it to new recordings. The raw alignment cosine misses this, since a constant predictor scores 0.793. Across 34 runs, the more identity a student memorises, the less state it learns. Fixed-effects distillation subtracts each recording's mean from prediction and target, so the trait cancels exactly, while a pooled anchor keeps it. State agreement more than doubles, within-person labels improve while age and sex do not, and the gain holds on two backbones and two further databases. Conditioning on the recording turns distillation toward the within-person changes that wearables monitor.

cs.LG↗

arXiv2026

P2E-VQ: ECG-linked representation augmentation for PPG via discrete patch retrieval

Photoplethysmography (PPG) is widely used in consumer wearables because of its low cost and ease of acquisition. However, unlike electrocardiography (ECG), PPG measures peripheral pulse dynamics rather than cardiac electrical activity, limiting its ability to predict cardiac conditions that rely on ECG-specific morphological cues. Existing methods attempt to bridge this gap by reconstructing ECG signals from PPG signals. However, this inverse mapping is inherently ill-posed, and faithful waveform reconstruction does not necessarily translate into improved downstream performance. To address this challenge, we propose P2E-VQ, a retrieval-augmented framework that replaces ECG waveform reconstruction with ECG-linked representation retrieval. Specifically, P2E-VQ converts PPG patches into discrete tokens and retrieves ECG-linked information from a memory bank constructed exclusively from the training data. This process augments PPG representations while requiring only PPG signals during inference. Extensive experiments on five public datasets covering six downstream tasks, including clinical endpoint prediction and affective state recognition, demonstrate that P2E-VQ consistently outperforms pretrained baselines under a unified frozen-feature linear-probing protocol.

cs.LG↗

arXiv2026

RetiBridge: Bridging Quantitative Retinal Biomarkers and Qualitative Diagnosis with a Knowledge-Guided Multimodal Large Language Model

Retinal biomarkers captured by color fundus photography and optical coherence tomography provide clinically valuable evidence for both ocular and systemic diseases. Multimodal large language models (MLLMs) have shown promise for retinal image interpretation, yet existing ophthalmic models rarely quantify these clinically relevant biomarkers or explicitly translate their measurements into qualitative, evidence-grounded diagnostic conclusions. To address this gap, we introduce RetiBridge, a knowledge-guided multimodal large language model that jointly analyzes color fundus photography (CFP), optical coherence tomography (OCT), and text, explicitly bridging quantitative retinal biomarkers to qualitative clinical sub-inferences and coherent diagnostic conclusions. RetiBridge combines knowledge-guided instruction generation, OCT-biomarker alignment, and supervised multimodal instruction tuning to learn a biomarker-grounded quantitative-to-qualitative diagnostic pathway. Using 15,611 paired CFP-OCT samples from UK Biobank with 31 OCT and 6 CFP biomarkers, we construct the Grounded Ophthalmic Understanding benchmark to evaluate diagnostic classification, report generation quality, and fine-grained clinical quality. Despite using only LoRA-based fine-tuning of a 7B-parameter Qwen2 backbone, RetiBridge outperforms all evaluated open-source 7B and 32B baselines, achieving the highest quantitative accuracy, evidence grounding, coverage completeness, and BERTScore, while surpassing OpenAI o3 on these key biomarker-grounded metrics. Our code and data are released in the RetiBridge repository.

cs.AI↗

arXiv2026

MedBench v5: A Dynamic, Process-Oriented, and Hallucination-Aware Benchmark for Clinical Multimodal Models

Existing medical AI benchmarks lack process visibility, atomic skill evaluation, and integrated hallucination detection. We introduce MedBench v5, a redesigned benchmark for clinical multimodal models (language, vision-language, and agent systems) that moves from static QA to dynamic, process-oriented evaluation. MedBench v5 features: (1) a dual-dimensional framework combining Clinical Cognitive Responsiveness (13 sub-dimensions) and Medical Atomic Skills (4 agent environments), covering 63 tasks; (2) three switchable information-flow stressors (omission, contradiction, evidence delay) for factorized degradation analysis; (3) a dynamic process audit protocol with five reasoning nodes that produces model-specific failure fingerprints; (4) hallucination propagation monitoring across initiation, propagation, anchoring, and contradiction interaction-capturing silent hallucination. Experiments on frontier models show that strong overall task performance does not guarantee process stability: stressors mainly disrupt contradiction detection, diagnosis updating, hallucination propagation, and contradiction-based self-correction, while final evidence grounding can remain superficially stable. MedBench v5 provides a unified infrastructure for capability profiling, controllable stress testing, process auditing, and hallucination trajectory analysis in clinical AI evaluation.

cs.CL↗

arXiv2026

HadBalance: A Plug-and-Play Unified Global Geometric Prior Framework for Generalizable Biomedical Segmentation

Precise biomedical image segmentation is crucial for clinical diagnosis. Geometric cues (e.g., boundary, shape, and topology) can improve structural consistency, yet most are task-specific and lack a unified geometric foundation that generalizes across organs and modalities. We are motivated by the observation that several medical segmentation targets can be approximated as globally near-convex shapes. A convex region is one in which any two interior points can be connected by a line segment entirely contained within the region. In practice, medical targets may exhibit small local concavities or boundary irregularities; we refer to such globally convex-like shapes as near-convex. Motivated by this, we derive Hadwiger Shape Priors from Hadwiger's theorem as an interpretable global regularizer using three 2D measures: area A, perimeter P, and Euler characteristic chi, enabling transfer across organs and modalities. However, because medical datasets are shape-heterogeneous, enforcing near-convex priors uniformly can over-regularize non-convex anatomy with significant concavities, washing out concavities and fine details and degrading segmentation accuracy. To address this challenge, we propose Conflict-Aware Objective Balancing (CAOB), which integrates shape priors with segmentation in a gradient-aware manner. For each prior, CAOB removes only the gradient component that conflicts with segmentation while preserving the remaining aligned component, and adaptively regulates objective influences to prevent prior dominance. This enables stable use of shape priors on shape-heterogeneous data without erasing genuine concavities or fine structural details. We call this plug-and-play framework HadBalance.

cs.CV↗

arXiv2026

Disentangled Fine-Grained Prototype Learning for Incomplete Image-Tabular Classification

The missing-modality problem poses a significant challenge in image-tabular multimodal learning across a wide range of multimedia applications, including product understanding, recommendation systems, and medical diagnosis. This challenge is particularly pronounced when the two modalities are highly heterogeneous, as images and tabular attributes differ substantially in their semantic granularity and data distributions. Existing methods learn modality-invariant representations through disentanglement and alignment over global token-averaged features, capturing only coarse cross-modal consistency and overlooking fine-grained semantic and distributional misalignment, which hampers the exploitation of complementary cues under missing modalities. To address this, we propose DFPL, a novel framework for fine-grained prototype learning. Specifically, Shared-Specific Prototype Modeling (SSPM) extracts compact and diverse shared and modality-specific prototypes, and further performs prototype-level disentanglement to suppress redundant intra-modality correlations. Additionally, we propose a Prototype-guided Fine-grained Alignment (PFA) module that jointly enforces prototype-level distribution matching and prototype-to-class semantic alignment within a unified prototype space, thereby preserving both fine-grained distributional and semantic consistency across modalities. We further introduce a Class-aware Multi-scale Aggregation (CMA) module to adaptively aggregate shared semantics and modality-specific characteristics from global and prototype levels for robust predictions. Extensive experiments on three diverse image-tabular benchmarks demonstrate the superiority of our method compared to the previous approaches under various missing-modality settings. Code will be made publicly available.

cs.CV↗

arXiv2026

SafeMed-R1: Clinician-Audited Safety and Ethics Alignment for Medical Large Language Models

Large language models(LLMs) increasingly match expert performance on licensing examinations, yet routine clinical use remains limited because governance requires auditable reasoning, safety and ethics alignment, and resilience to adversarial misuse. Here we present SafeMed-R1, trained with a traceable Clinical Trust Signals(CTS) pipeline that links each reasoning instance to clinician rubric scores and edit histories, and aligned through safety and ethics supervision and red team stress testing. SafeMed-R1 attains a macro-averaged accuracy of 79.6% across clinical benchmarks. Under adversarial safety testing, it shows the lowest aggregated risk and reduces unsafe outputs by about 3 to 5% relative to its baseline. In a paired expert study of 30 medication safety vignettes, SafeMed-R1 matches PGY1 and PGY2 residents on medical correctness and scores higher for medication safety, guideline consistency, and clinical usefulness. Collectively, these results suggest that clinician-audited supervision provenance, together with domain-tailored safety and ethics alignment, can strengthen governance-relevant evidence without relying on inference-time retrieval or citation grounding.

cs.AI↗

arXiv2026

Interpreting V1 Population Activity via Image-Neural Latent Representation Alignment

Understanding the neural mechanisms underlying visual computation has long been a central challenge in neuroscience. Recent alignment based approaches have improved the accuracy of decoding visual stimuli from brain activity, yet they provide limited insight into the neural computations that give rise to these improvements. To address this gap, we propose Dual-Tower Image-Neural Alignment (DINA), an interpretable contrastive framework for analyzing population level visual computations in primary visual cortex (V1). DINA jointly trains a biologically motivated dual-tower architecture that aligns visual stimuli and corresponding V1 population responses in a shared latent space at the level of intermediate feature maps, enabling both accurate decoding and direct access to interpretable feature maps. Evaluated on large-scale two-photon calcium imaging data from mouse V1, DINA achieves accurate neural-based decoding while revealing that decoding performance is primarily supported by coarse, low-level visual structure, rather than semantic category information or fine-grained details. Further analysis reveals that alignable feature maps emerge from multiple spatially distributed image regions, capturing both shape and texture cues, and are predominantly reconstructed by sparse subsets of strongly responsive neurons and their functional interactions. Together, these results confirm that, beyond enabling accurate decoding, DINA provides a principled framework for probing the computational mechanisms underlying visual processing in V1.

cs.NE↗

arXiv2026

Leveraging Persistence Image to Enhance Robustness and Performance in Curvilinear Structure Segmentation

Segmenting curvilinear structures in medical images is essential for analyzing morphological patterns in clinical applications. Integrating topological properties, such as connectivity, improves segmentation accuracy and consistency. However, extracting and embedding such properties - especially from Persistence Diagrams (PD) - is challenging due to their non-differentiability and computational cost. Existing approaches mostly encode topology through handcrafted loss functions, which generalize poorly across tasks. In this paper, we propose PIs-Regressor, a simple yet effective module that learns persistence image (PI) - finite, differentiable representations of topological features - directly from data. Together with Topology SegNet, which fuses these features in both downsampling and upsampling stages, our framework integrates topology into the network architecture itself rather than auxiliary losses. Unlike existing methods that depend heavily on handcrafted loss functions, our approach directly incorporates topological information into the network structure, leading to more robust segmentation. Our design is flexible and can be seamlessly combined with other topology-based methods to further enhance segmentation performance. Experimental results show that integrating topological features enhances model robustness, effectively handling challenges like overexposure and blurring in medical imaging. Our approach on three curvilinear benchmarks demonstrate state-of-the-art performance in both pixel-level accuracy and topological fidelity.

cs.CV↗

arXiv2025

GLCP: Global-to-Local Connectivity Preservation for Tubular Structure Segmentation

Accurate segmentation of tubular structures, such as vascular networks, plays a critical role in various medical domains. A remaining significant challenge in this task is structural fragmentation, which can adversely impact downstream applications. Existing methods primarily focus on designing various loss functions to constrain global topological structures. However, they often overlook local discontinuity regions, leading to suboptimal segmentation results. To overcome this limitation, we propose a novel Global-to-Local Connectivity Preservation (GLCP) framework that can simultaneously perceive global and local structural characteristics of tubular networks. Specifically, we propose an Interactive Multi-head Segmentation (IMS) module to jointly learn global segmentation, skeleton maps, and local discontinuity maps, respectively. This enables our model to explicitly target local discontinuity regions while maintaining global topological integrity. In addition, we design a lightweight Dual-Attention-based Refinement (DAR) module to further improve segmentation quality by refining the resulting segmentation maps. Extensive experiments on both 2D and 3D datasets demonstrate that our GLCP achieves superior accuracy and continuity in tubular structure segmentation compared to several state-of-the-art approaches. The source codes will be available at https://github.com/FeixiangZhou/GLCP.

cs.CV↗