Scaling Recurrence-aware Foundation Models for Clinical Records via Next-Visit Prediction

While large-scale pretraining has revolutionized language modeling, its potential remains underexplored in healthcare with structured electronic health records (EHRs). We present RAVEN, a novel generative pretraining strategy for sequential EHR data based on Recurrence-Aware next-Visit EveNt prediction. Leveraging a dataset of over one million unique individuals, our model learns to autoregressively generate tokenized clinical events for the next visit conditioned on patient history. We introduce regularization on predicting repeated events and highlight a key pitfall in EHR-based foundation model evaluations: repeated event tokens can inflate performance metrics when new onsets are not distinguished from subsequent occurrences. Furthermore, we empirically investigate the scaling behaviors in a data-constrained, compute-saturated regime, showing that simply increasing model size is suboptimal without commensurate increases in data volume. We evaluate our model via zero-shot prediction for forecasting the incidence of a diverse set of diseases, where it rivals fully fine-tuned representation-based Transformer models and outperforms widely used simulation-based next-token approaches. Finally, without additional parameter updates, we show that RAVEN can generalize to an external patient cohort under lossy clinical code mappings and feature coverage gaps.

Active Robotic Perception for Disease Detection and Mapping in Apple Trees

Large-scale orchard production requires timely and precise disease monitoring, yet routine manual scouting is labor-intensive and financially impractical at the scale of modern operations. As a result, disease outbreaks are often detected late and tracked at coarse spatial resolutions, typically at the orchard-block level. We present an autonomous mobile active perception system for targeted disease detection and mapping in dormant apple trees, demonstrated on one of the most devastating diseases affecting apple today -- fire blight. The system integrates flash-illuminated stereo RGB sensing, real-time depth estimation, instance-level segmentation, and confidence-aware semantic 3D mapping to achieve precise localization of disease symptoms. Semantic predictions are fused into the volumetric occupancy map representation enabling the tracking of both occupancy and per-voxel semantic confidence, building actionable spatial maps for growers. To actively refine observations within complex canopies, we evaluate three viewpoint planning strategies within a unified perception-action loop: a deterministic geometric baseline, a volumetric next-best-view planner that maximizes unknown-space reduction, and a semantic next-best-view planner that prioritizes low-confidence symptomatic regions. Experiments on a fabricated lab tree and five simulated symptomatic trees demonstrate reliable symptom localization and mapping as a precursor to a field evaluation. In simulation, the semantic planner achieves the highest F1 score (0.6106) after 30 viewpoints, while the volumetric planner achieves the highest ROI coverage (85.82\%). In the lab setting, the semantic planner attains the highest final F1 (0.9058), with both next-best-view planners substantially improving coverage over the baseline.

Vision-based Deep Learning Analysis of Unordered Biomedical Tabular Datasets via Optimal Spatial Cartography

Tabular data are central to biomedical research, from liquid biopsy and bulk and single-cell transcriptomics to electronic health records and phenotypic profiling. Unlike images or sequences, however, tabular datasets lack intrinsic spatial organization: features are treated as unordered dimensions, and their relationships must be inferred implicitly by the model. This limits the ability of vision architectures to exploit local structure and higher-order feature interactions in non-spatial biomedical data. Here we introduce Dynamic Feature Mapping (Dynomap), an end-to-end deep learning framework that learns a task-optimized spatial topology of features directly from data. Dynomap jointly optimizes feature placement and prediction through a fully differentiable rendering mechanism, without relying on heuristics, predefined groupings, or external priors. By transforming high-dimensional tabular vectors into learned feature maps, Dynomap enables vision-based models to operate effectively on unordered biomedical inputs. Across multiple clinical and biological datasets, Dynomap consistently outperformed classical machine learning, modern deep tabular models, and existing vector-to-image approaches. In liquid biopsy data, Dynomap organized clinically relevant gene signatures into coherent spatial patterns and improved multiclass cancer subtype prediction accuracy by up to 18%. In a Parkinson disease voice dataset, it clustered disease-associated acoustic descriptors and improved accuracy by up to 8%. Similar gains and interpretable feature organization were observed in additional biomedical datasets. These results establish Dynomap as a general strategy for bridging tabular and vision-based deep learning and for uncovering structured, clinically relevant patterns in high-dimensional biomedical data.

Clinical Graph-Mediated Distillation for Unpaired MRI-to-CFI Hypertension Prediction

Retinal fundus imaging enables low-cost and scalable hypertension (HTN) screening, but HTN-related retinal cues are subtle, yielding high-variance predictions. Brain MRI provides stronger vascular and small-vessel-disease markers of HTN, yet it is expensive and rarely acquired alongside fundus images, resulting in modality-siloed datasets with disjoint MRI and fundus cohorts. We study this unpaired MRI-fundus regime and introduce Clinical Graph-Mediated Distillation (CGMD), a framework that transfers MRI-derived HTN knowledge to a fundus model without paired multimodal data. CGMD leverages shared structured biomarkers as a bridge by constructing a clinical similarity kNN graph spanning both cohorts. We train an MRI teacher, propagate its representations over the graph, and impute brain-informed representation targets for fundus patients. A fundus student is then trained with a joint objective combining HTN supervision, target distillation, and relational distillation. Experiments on our newly collected unpaired MRI-fundus-biomarker dataset show that CGMD consistently improves fundus-based HTN prediction over standard distillation and non-graph imputation baselines, with ablations confirming the importance of clinically grounded graph connectivity. Code is available at https://github.com/DillanImans/CGMD-unpaired-distillation.

Chronological Contrastive Learning: Few-Shot Progression Assessment in Irreversible Diseases

Quantitative disease severity scoring in medical imaging is costly, time-consuming, and subject to inter-reader variability. At the same time, clinical archives contain far more longitudinal imaging data than expert-annotated severity scores. Existing self-supervised methods typically ignore this chronological structure. We introduce ChronoCon, a contrastive learning approach that replaces label-based ranking losses with rankings derived solely from the visitation order of a patient's longitudinal scans. Under the clinically plausible assumption of monotonic progression in irreversible diseases, the method learns disease-relevant representations without using any expert labels. This generalizes the idea of Rank-N-Contrast from label distances to temporal ordering. Evaluated on rheumatoid arthritis radiographs for severity assessment, the learned representations substantially improve label efficiency. In low-label settings, ChronoCon significantly outperforms a fully supervised baseline initialized from ImageNet weights. In a few-shot learning experiment, fine-tuning ChronoCon on expert scores from only five patients yields an intraclass correlation coefficient of 86% for severity score prediction. These results demonstrate the potential of chronological contrastive learning to exploit routinely available imaging metadata to reduce annotation requirements in the irreversible disease domain. Code is available at https://github.com/cirmuw/ChronoCon.

Bi-CRCL: Bidirectional Conservative-Radical Complementary Learning with Pre-trained Foundation Models for Class-incremental Medical Image Analysis

Class-incremental learning (CIL) in medical image-guided diagnosis requires retaining prior diagnostic knowledge while adapting to newly emerging disease categories, which is critical for scalable clinical deployment. This problem is particularly challenging due to heterogeneous data and privacy constraints that prevent memory replay. Although pretrained foundation models (PFMs) have advanced general-domain CIL, their potential in medical imaging remains underexplored, where domain-specific adaptation is essential yet difficult due to anatomical complexity and inter-institutional heterogeneity. To address this gap, we conduct a systematic benchmark of recent PFM-based CIL methods and propose Bidirectional Conservative-Radical Complementary Learning (Bi-CRCL), a dual-learner framework inspired by complementary learning systems. Bi-CRCL integrates a conservative learner that preserves prior knowledge through stability-oriented updates and a radical learner that rapidly adapts to new categories via plasticity-oriented learning. A bidirectional interaction mechanism enables forward transfer and backward consolidation, allowing continual integration of new knowledge while mitigating catastrophic forgetting. During inference, outputs from both learners are adaptively fused for robust predictions. Experiments on five medical imaging datasets demonstrate consistent improvements over state-of-the-art methods under diverse settings, including cross-dataset shifts and varying task configurations.

Hierarchical Multiscale Structure-Function Coupling for Brain Connectome Integration

Integrating structural and functional connectomes remains challenging because their relationship is non-linear and organized over nested modular hierarchies. We propose a hierarchical multiscale structure-function coupling framework for connectome integration that jointly learns individualized modular organization and hierarchical coupling across structural connectivity (SC) and functional connectivity (FC). The framework includes: (i) Prototype-based Modular Pooling (PMPool), which learns modality-specific multiscale communities by selecting prototypical ROIs and optimizing a differentiable modularity-inspired objective; (ii) an Attention-based Hierarchical Coupling Module (AHCM) that models both within-hierarchy and cross-hierarchy SC-FC interactions to produce enriched hierarchical coupling representations; and (iii) a Coupling-guided Clustering loss (CgC-Loss) that regularizes SC and FC community assignments with coupling signals, allowing cross-modal interactions to shape community alignment across hierarchies. We evaluate the model's performance across four cohorts for predicting brain age, cognitive score, and disease classification. Our model consistently outperforms baselines and other state-of-the-art approaches across three tasks. Ablation and sensitivity analyses verify the contributions of key components. Finally, the visualizations of learned coupling reveal interpretable differences, suggesting that the framework captures biologically meaningful structure-function relationships.

BVSIMC: Bayesian Variable Selection-Guided Inductive Matrix Completion for Improved and Interpretable Drug Discovery

Recent advances in drug discovery have demonstrated that incorporating side information (e.g., chemical properties about drugs and genomic information about diseases) often greatly improves prediction performance. However, these side features can vary widely in relevance and are often noisy and high-dimensional. We propose Bayesian Variable Selection-Guided Inductive Matrix Completion (BVSIMC), a new Bayesian model that enables variable selection from side features in drug discovery. By learning sparse latent embeddings, BVSIMC improves both predictive accuracy and interpretability. We validate our method through simulation studies and two drug discovery applications: 1) prediction of drug resistance in Mycobacterium tuberculosis, and 2) prediction of new drug-disease associations in computational drug repositioning. On both synthetic and real data, BVSIMC outperforms several other state-of-the-art methods in terms of prediction. In our two real examples, BVSIMC further reveals the most clinically meaningful side features.

Tabular LLMs for Interpretable Few-Shot Alzheimer's Disease Prediction with Multimodal Biomedical Data

Accurate diagnosis of Alzheimer's disease (AD) requires handling tabular biomarker data, yet such data are often small and incomplete, where deep learning models frequently fail to outperform classical methods. Pretrained large language models (LLMs) offer few-shot generalization, structured reasoning, and interpretable outputs, providing a powerful paradigm shift for clinical prediction. We propose TAP-GPT Tabular Alzheimer's Prediction GPT, a domain-adapted tabular LLM framework built on TableGPT2 and fine-tuned for few-shot AD classification using tabular prompts rather than plain texts. We evaluate TAP-GPT across four ADNI-derived datasets, including QT-PAD biomarkers and region-level structural MRI, amyloid PET, and tau PET for binary AD classification. Across multimodal and unimodal settings, TAP-GPT improves upon its backbone models and outperforms traditional machine learning baselines in the few-shot setting while remaining competitive with state-of-the-art general-purpose LLMs. We show that feature selection mitigates degradation in high-dimensional inputs and that TAP-GPT maintains stable performance under simulated and real-world missingness without imputation. Additionally, TAP-GPT produces structured, modality-aware reasoning aligned with established AD biology and shows greater stability under self-reflection, supporting its use in iterative multi-agent systems. To our knowledge, this is the first systematic application of a tabular-specialized LLM to multimodal biomarker-based AD prediction, demonstrating that such pretrained models can effectively address structured clinical prediction tasks and laying the foundation for tabular LLM-driven multi-agent clinical decision-support systems. The source code is publicly available on GitHub: https://github.com/sophie-kearney/TAP-GPT.

G2DR: A Genotype-First Framework for Genetics-Informed Target Prioritization and Drug Repurposing

Human genetics offers a promising route to therapeutic discovery, yet practical frameworks translating genotype-derived signal into ranked target and drug hypotheses remain limited, particularly when matched disease transcriptomics are unavailable. Here we present G2DR, a genotype-first prioritization framework propagating inherited variation through genetically predicted expression, multi-method gene-level testing, pathway enrichment, network context, druggability, and multi-source drug--target evidence integration. In a migraine case study with 733 UK Biobank participants under stratified five-fold cross-validation, we imputed expression across seven transcriptome-weight resources and ranked genes using a reproducibility-aware discovery score from training and validation data, followed by a balanced integrated score for target selection. Discovery-based prioritization generalized to held-out data, achieving gene-level ROC-AUC of 0.775 and PR-AUC of 0.475, while retaining enrichment for curated migraine biology. Mapping prioritized genes to compounds via Open Targets, DGIdb, and ChEMBL yielded drug sets enriched for migraine-linked compounds relative to a global background, though recovery favoured broader mechanism-linked and off-label space over migraine-specific approved therapies. Directionality filtering separated broadly recovered compounds from mechanistically compatible candidates. G2DR is a modular framework for genetics-informed hypothesis generation, not a clinically actionable recommendation system. All outputs require independent experimental, pharmacological, and clinical validation.