Robotic transcatheter tricuspid valve replacement with hybrid enhanced intelligence: a new paradigm and first-in-vivo study

Transcatheter tricuspid valve replacement (TTVR) is the latest treatment for tricuspid regurgitation and is in the early stages of clinical adoption. Intelligent robotic approaches are expected to overcome the challenges of surgical manipulation and widespread dissemination, but systems and protocols with high clinical utility have not yet been reported. In this study, we propose a complete solution that includes a passive stabilizer, robotic drive, detachable delivery catheter and valve manipulation mechanism. Working towards autonomy, a hybrid augmented intelligence approach based on reinforcement learning, Monte Carlo probabilistic maps and human-robot co-piloted control was introduced. Systematic tests in phantom and first-in-vivo animal experiments were performed to verify that the system design met the clinical requirement. Furthermore, the experimental results confirmed the advantages of co-piloted control over conventional master-slave control in terms of time efficiency, control efficiency, autonomy and stability of operation. In conclusion, this study provides a comprehensive pathway for robotic TTVR and, to our knowledge, completes the first animal study that not only successfully demonstrates the application of hybrid enhanced intelligence in interventional robotics, but also provides a solution with high application value for a cutting-edge procedure.

Advancing Multimodal Large Language Models in Chart Question Answering with Visualization-Referenced Instruction Tuning

Emerging multimodal large language models (MLLMs) exhibit great potential for chart question answering (CQA). Recent efforts primarily focus on scaling up training datasets (i.e., charts, data tables, and question-answer (QA) pairs) through data collection and synthesis. However, our empirical study on existing MLLMs and CQA datasets reveals notable gaps. First, current data collection and synthesis focus on data volume and lack consideration of fine-grained visual encodings and QA tasks, resulting in unbalanced data distribution divergent from practical CQA scenarios. Second, existing work follows the training recipe of the base MLLMs initially designed for natural images, under-exploring the adaptation to unique chart characteristics, such as rich text elements. To fill the gap, we propose a visualization-referenced instruction tuning approach to guide the training dataset enhancement and model development. Specifically, we propose a novel data engine to effectively filter diverse and high-quality data from existing datasets and subsequently refine and augment the data using LLM-based generation techniques to better align with practical QA tasks and visual encodings. Then, to facilitate the adaptation to chart characteristics, we utilize the enriched data to train an MLLM by unfreezing the vision encoder and incorporating a mixture-of-resolution adaptation strategy for enhanced fine-grained recognition. Experimental results validate the effectiveness of our approach. Even with fewer training examples, our model consistently outperforms state-of-the-art CQA models on established benchmarks. We also contribute a dataset split as a benchmark for future research. Source codes and datasets of this paper are available at https://github.com/zengxingchen/ChartQA-MLLM.