Diagnosing pulmonary diseases requires integrating heterogeneous evidence amid phenotypic variability and cross-disease overlap. Although large language models (LLMs) have shown progress on pulmonary knowledge question answering (QA) and information-processing tasks, reliable pulmonary diagnosis requires patient-specific, relation-aware reasoning over electronic medical record (EMR) evidence rather than isolated knowledge recall. We define this gap between pulmonary knowledge and case-level diagnostic reasoning as the Pulmonary Knowledge-to-Diagnosis Gap. To address it, we introduce LungKG, the first structured pulmonary knowledge graph for diagnostic knowledge organization and record-grounded reasoning. LungKG contains 59,038 nodes and 164,308 edges across 15 entity types and 112 relation types, serving as both a reusable pulmonary knowledge resource and the foundation for LungKG-guided model adaptation. Built on LungKG, we propose Lung-R1, a LungKG-guided pulmonary LLM trained through KG-constrained reasoning-chain construction and KG-guided reinforcement learning. In a 20-system evaluation, Lung-R1-14B achieves state-of-the-art performance across Choice, Pulmonary-QA, and EMR Di
Auscultation is a method for diagnosis of especially internal medicine diseases such as cardiac, pulmonary and cardio-pulmonary by listening the internal sounds from the body parts. It is the simplest and the most common physical examination in the assessment processes of the clinical skills. In this study, the lung and heart sounds are recorded synchronously from left and right sides of posterior and anterior chest wall and back using two digital stethoscopes in Antakya State Hospital. The chest X-rays and the pulmonary function test variables and spirometric curves, the St. George respiratory questionnaire (SGRQ-C) are collected as multimedia and clinical functional analysis variables of the patients. The 4 channels of heart sounds are focused on aortic, pulmonary, tricuspid and mitral areas. The 12 channels of lung sounds are focused on upper lung, middle lung, lower lung and costophrenic angle areas of posterior and anterior sides of the chest. The recordings are validated and labelled by two pulmonologists evaluating the collected chest x-ray, PFT and auscultation sounds of the subjects. The database consists of 30 healthy subjects and 45 subjects with pulmonary diseases such
Medicine, including fields in healthcare and life sciences, has seen a flurry of quantum-related activities and experiments in the last few years (although biology and quantum theory have arguably been entangled ever since Schrödinger's cat). The initial focus was on biochemical and computational biology problems; recently, however, clinical and medical quantum solutions have drawn increasing interest. The rapid emergence of quantum computing in health and medicine necessitates a mapping of the landscape. In this review, clinical and medical proof-of-concept quantum computing applications are outlined and put into perspective. These consist of over 40 experimental and theoretical studies. The use case areas span genomics, clinical research and discovery, diagnostics, and treatments and interventions. Quantum machine learning (QML) in particular has rapidly evolved and shown to be competitive with classical benchmarks in recent medical research. Near-term QML algorithms have been trained with diverse clinical and real-world data sets. This includes studies in generating new molecular entities as drug candidates, diagnosing based on medical image classification, predicting patient pe
Auscultation is a key method for early diagnosis of respiratory and pulmonary diseases, relying on skilled healthcare professionals. However, the process is often subjective, with variability between experts. As a result, numerous deep learning-based automatic classification methods have emerged, most of which focus on respiratory sound classification. In contrast, research on respiratory sound event detection remains limited. Existing sound event detection methods typically rely on frame-level predictions followed by post-processing to generate event-level outputs, making interval boundaries challenging to learn directly. Furthermore, many approaches can only handle fixed-length audio, limiting their applicability to variable-length respiratory sounds. Additionally, the impact of respiratory sound location information on detection performance has not been extensively explored. To address these issues, we propose a graph neural network-based framework with anchor intervals, capable of handling variable-length audio and providing more precise temporal localization for abnormal respiratory sound events. Our method improves both the flexibility and applicability of respiratory sound d
This paper presents an explainable artificial intelligence (XAI)-based framework for the spectral analysis of cough sounds associated with chronic respiratory diseases, with a particular focus on Chronic Obstructive Pulmonary Disease (COPD). A Convolutional Neural Network (CNN) is trained on time-frequency representations of cough signals, and occlusion maps are used to identify diagnostically relevant regions within the spectrograms. These highlighted areas are subsequently decomposed into five frequency subbands, enabling targeted spectral feature extraction and analysis. The results reveal that spectral patterns differ across subbands and disease groups, uncovering complementary and compensatory trends across the frequency spectrum. Noteworthy, the approach distinguishes COPD from other respiratory conditions, and chronic from non-chronic patient groups, based on interpretable spectral markers. These findings provide insight into the underlying pathophysiological characteristics of cough acoustics and demonstrate the value of frequency-resolved, XAI-enhanced analysis for biomedical signal interpretation and translational respiratory disease diagnostics.
Respiratory sound analysis is a crucial tool for screening asthma and other pulmonary pathologies, yet traditional auscultation remains subjective and experience-dependent. Our prior research established a CNN baseline using DenseNet201, which demonstrated high sensitivity in classifying respiratory sounds. In this work, we (i) adapt the Audio Spectrogram Transformer (AST) for respiratory sound analysis and (ii) evaluate a multimodal Vision-Language Model (VLM) that integrates spectrograms with structured patient metadata. AST is initialized from publicly available weights and fine-tuned on a medical dataset containing hundreds of recordings per diagnosis. The VLM experiment uses a compact Moondream-type model that processes spectrogram images alongside a structured text prompt (sex, age, recording site) to output a JSON-formatted diagnosis. Results indicate that AST achieves approximately 97% accuracy with an F1-score around 97% and ROC AUC of 0.98 for asthma detection, significantly outperforming both the internal CNN baseline and typical external benchmarks. The VLM reaches 86-87% accuracy, performing comparably to the CNN baseline while demonstrating the capability to integrate
Respiratory diseases impose a significant burden on global health, with current diagnostic and management practices primarily reliant on specialist clinical testing. This work aims to develop machine learning-based algorithms to facilitate at-home respiratory disease monitoring and assessment for patients undergoing continuous positive airway pressure (CPAP) therapy. Data were collected from 30 healthy adults, encompassing respiratory pressure, flow, and dynamic thoraco-abdominal circumferential measurements under three breathing conditions: normal, panting, and deep breathing. Various machine learning models, including the random forest classifier, logistic regression, and support vector machine (SVM), were trained to predict breathing types. The random forest classifier demonstrated the highest accuracy, particularly when incorporating breathing rate as a feature. These findings support the potential of AI-driven respiratory monitoring systems to transition respiratory assessments from clinical settings to home environments, enhancing accessibility and patient autonomy. Future work involves validating these models with larger, more diverse populations and exploring additional mac
Model Medicine is the science of understanding, diagnosing, treating, and preventing disorders in AI models, grounded in the principle that AI models -- like biological organisms -- have internal structures, dynamic processes, heritable traits, observable symptoms, classifiable conditions, and treatable states. This paper introduces Model Medicine as a research program, bridging the gap between current AI interpretability research (anatomical observation) and the systematic clinical practice that complex AI systems increasingly require. We present five contributions: (1) a discipline taxonomy organizing 15 subdisciplines across four divisions -- Basic Model Sciences, Clinical Model Sciences, Model Public Health, and Model Architectural Medicine; (2) the Four Shell Model (v3.3), a behavioral genetics framework empirically grounded in 720 agents and 24,923 decisions from the Agora-12 program, explaining how model behavior emerges from Core--Shell interaction; (3) Neural MRI (Model Resonance Imaging), a working open-source diagnostic tool mapping five medical neuroimaging modalities to AI interpretability techniques, validated through four clinical cases demonstrating imaging, compari
What does Artificial Intelligence (AI) have to contribute to health care? And what should we be looking out for if we are worried about its risks? In this paper we offer a survey, and initial evaluation, of hopes and fears about the applications of artificial intelligence in medicine. AI clearly has enormous potential as a research tool, in genomics and public health especially, as well as a diagnostic aid. It's also highly likely to impact on the organisational and business practices of healthcare systems in ways that are perhaps under-appreciated. Enthusiasts for AI have held out the prospect that it will free physicians up to spend more time attending to what really matters to them and their patients. We will argue that this claim depends upon implausible assumptions about the institutional and economic imperatives operating in contemporary healthcare settings. We will also highlight important concerns about privacy, surveillance, and bias in big data, as well as the risks of over trust in machines, the challenges of transparency, the deskilling of healthcare practitioners, the way AI reframes healthcare, and the implications of AI for the distribution of power in healthcare ins
Pulmonary embolism, the obstruction of a pulmonary artery by a blood clot, is one of the leading causes of acute cardiovascular syndrome. In clinical practice, therapeutic decisions after diagnosis via computed tomography pulmonary angiography rely on risk stratification, which categorizes 30-day mortality risk into three categories. This stratification depends on the right-to-left ventricular diameter ratio and blood levels of two cardiac enzymes. However, blood biomarkers are not always available in emergency settings, and manual calculation of established severity scores - such as Qanadli and Mastora - is time-consuming and rarely performed in clinical routine practice. This study introduces an automated pipeline that models a directed graph representation of the pulmonary arterial tree, labeling its hierarchical structure and characterizing pulmonary embolism. The pipeline derives image-based biomarkers, including local artery-level features (morphological information, hierarchical position, clot volume, and resulting obstruction) and global patient-level biomarkers such as automatically calculated severity scores (Qanadli and Mastora) and the total embolic volume distribution
Objective: Triaxial accelerometers (TAAs) are widely used in homecare medicine. This study investigates whether TAA signals recorded at the fingertip encode respiratory information, particularly instantaneous respiratory rate (IRR) and respiratory effort, during sleep. Method: We propose an antiderivative-based nonlinear transformation to convert TAA signals into a respiratory surrogate, termed TAA-resp. To quantify the embedded respiratory-induced motion, a modern time-frequency analysis tool is applied to derive an index, referred to as the respiratory motion index (RMI). The proposed TAA-resp and RMI are validated on a dataset comprising 39 full-night recordings with simultaneous polysomnography (PSG) and a fingertip TAA measurements. Criteria for labeling TAA-resp signal quality as good, moderate, or poor are established, and expert annotations are obtained. Result: On average, TAA-resp over 22.2% $\pm$ 15.6% of full-night recordings encodes high-quality respiratory information, reaching up to 58.9% in some cases. TAA-resp shows stronger correlation with thoracic and abdominal motion than with airflow, indicating predominant capture of respiratory effort. High-quality TAA-resp
Asthma is a common chronic disease of the respiratory system causing significant disability and societal burden. It affects more than 300 million people worldwide, while more than 100 million people will likely have asthma by 2025. The price of asthma varies greatly from nation to nation. Mean yearly cost can be estimated to 1900 EUR in Europe and $3100 in the United States. Managing asthma involves controlling symptoms, preventing exacerbations, and maintaining lung function. Improved asthma control is reduces the risk of exacerbations and lung function impairment while reducing the direct costs of asthma care and indirect costs associated with reduced productivity. Understanding the complex dynamics of the pulmonary system and the lung's response to disease is fundamental to the advancement of Asthma treatment. Computational models of the respiratory system seek to provide a theoretical framework to understand the interaction between structure and function. Their application can improve pulmonary medicine by a patient-specific approach to medicinal methodologies optimizing the delivery given the personalized geometry and personalized ventilation patterns. A three-fold objective i
Respiratory rate is a vital indicator of pulmonary and cardiovascular health, yet conventional methods for estimating respiratory rate are often intrusive due to their contact-based nature. Remote photoplethysmography offers a promising non-contact alternative and has been widely used for heart rate estimation; however, its potential for respiratory rate estimation remains underexplored. Existing methods typically adapt green and chrominance-based projections originally designed for heart rate estimation, which only partially capture respiratory dynamics. Most prior work focuses on the Eulerian representation with fixed or empirically selected RGB projections. To address these gaps, we propose a skin-tone-aware dynamic RGB signal projection that captures respiratory information. To mitigate the sensitivity of the Lagrangian representation to non-respiratory motion, we introduce a denoising network for motion-based remote photoplethysmography signals. We further design a phase-independent contrastive loss that enables Eulerian and Lagrangian representations to collaboratively learn respiratory rate information. We also introduce RR-rPPG, a respiratory-rate facial video dataset with
Chronic respiratory diseases, such as chronic obstructive pulmonary disease and asthma, are a serious health crisis, affecting a large number of people globally and inflicting major costs on the economy. Current methods for assessing the progression of respiratory symptoms are either subjective and inaccurate, or complex and cumbersome, and do not incorporate environmental factors. Lacking predictive assessments and early intervention, unexpected exacerbations can lead to hospitalizations and high medical costs. This work presents a multi-modal solution for predicting the exacerbation risks of respiratory diseases, such as COPD, based on a novel spatio-temporal machine learning architecture for real-time and accurate respiratory events detection, and tracking of local environmental and meteorological data and trends. The proposed new machine learning architecture blends key attributes of both convolutional and recurrent neural networks, allowing extraction of both spatial and temporal features encoded in respiratory sounds, thereby leading to accurate classification and tracking of symptoms. Combined with the data from environmental and meteorological sensors, and a predictive mode
Respiratory motion limits the accuracy and precision of abdominal percutaneous procedures. In this paper, respiratory motion is compensated robotically using motion estimation models. Additionally, a teleoperated insertion is performed using proximity-based haptic feedback to guide physicians during insertion, enabling a radiation-free remote insertion for the end-user. The study has been validated using a robotic liver phantom, and five insertions were performed. The resulting motion estimation errors were below 3 mm for all directions of motion, and the overall resulting 3D insertion errors were 2.60, 7.75, and 2.86 mm for the superior-inferior, lateral, and anterior-posterior directions of motion, respectively. The proposed approach is expected to minimize the chances of inaccurate treatment or diagnosis due to respiratory-induced motion and reduce radiation exposure.
This study examines the clinical decision-making processes in Traditional East Asian Medicine (TEAM) by reinterpreting pattern identification (PI) through the lens of dimensionality reduction. Focusing on the Eight Principle Pattern Identification (EPPI) system and utilizing empirical data from the Shang-Han-Lun, we explore the necessity and significance of prioritizing the Exterior-Interior pattern in diagnosis and treatment selection. We test three hypotheses: whether the Ext-Int pattern contains the most information about patient symptoms, represents the most abstract and generalizable symptom information, and facilitates the selection of appropriate herbal prescriptions. Employing quantitative measures such as the abstraction index, cross-conditional generalization performance, and decision tree regression, our results demonstrate that the Exterior-Interior pattern represents the most abstract and generalizable symptom information, contributing to the efficient mapping between symptom and herbal prescription spaces. This research provides an objective framework for understanding the cognitive processes underlying TEAM, bridging traditional medical practices with modern computat
Pulmonary hypertension (PH) can lead to significant vascular remodeling, resulting in altered pulmonary blood flow. Estimating the patient-specific contributions of each remodeling event is necessary to optimize and individualize clinical intervention strategies. In-silico modeling has emerged as a powerful tool to simulate pulmonary hemodynamics, and one of the primary requirements for robust in-silico modeling is an accurate representation of the pulmonary vasculature structure. Computed tomography (CT) imaging can be used to segment and reconstruct the proximal vasculature. However, contrast-enhanced imaging, such as CT pulmonary angiography, is required to obtain a comprehensive and high-fidelity view of the pulmonary vasculature. The clinical use of CT pulmonary angiography is limited by the complications associated with the injection of contrast agents. Machine learning (ML) approaches have emerged to effectively segment and reconstruct the pulmonary vasculature without the need for contrast-enhanced imaging. We have developed a method to create in-silico pulmonary angiogram phantoms with varying simulated contrast levels. The results indicated that adding simulated contrast
3D data from high-resolution volumetric imaging is a central resource for diagnosis and treatment in modern medicine. While the fast development of AI enhances imaging and analysis, commonly used visualization methods lag far behind. Recent research used extended reality (XR) for perceiving 3D images with visual depth perception and touch but used restrictive haptic devices. While unrestricted touch benefits volumetric data examination, implementing natural haptic interaction with XR is challenging. The research question is whether a multisensory XR application with intuitive haptic interaction adds value and should be pursued. In a study, 24 experts for biomedical images in research and medicine explored 3D medical shapes with 3 applications: a multisensory virtual reality (VR) prototype using haptic gloves, a simple VR prototype using controllers, and a standard PC application. Results of standardized questionnaires showed no significant differences between all application types regarding usability and no significant difference between both VR applications regarding presence. Participants agreed to statements that VR visualizations provide better depth information, using the hand
Pulmonary embolism is a life-threatening disease, early detection and treatment can significantly reduce mortality. In recent years, many studies have been using deep learning in the diagnosis of pulmonary embolism with contrast medium computed tomography pulmonary angiography, but the contrast medium is likely to cause acute kidney injury in patients with pulmonary embolism and chronic kidney disease, and the contrast medium takes time to work, patients with acute pulmonary embolism may miss the golden treatment time. This study aims to use deep learning techniques to automatically classify pulmonary embolism in CT images without contrast medium by using a 3D convolutional neural network model. The deep learning model used in this study had a significant impact on the pulmonary embolism classification of computed tomography images without contrast with 85\% accuracy and 0.84 AUC, which confirms the feasibility of the model in the diagnosis of pulmonary embolism.
Accurate segmentation of pulmonary airways and vessels is crucial for the diagnosis and treatment of pulmonary diseases. However, current deep learning approaches suffer from disconnectivity issues that hinder their clinical usefulness. To address this challenge, we propose a post-processing approach that leverages a data-driven method to repair the topology of disconnected pulmonary tubular structures. Our approach formulates the problem as a keypoint detection task, where a neural network is trained to predict keypoints that can bridge disconnected components. We use a training data synthesis pipeline that generates disconnected data from complete pulmonary structures. Moreover, the new Pulmonary Tree Repairing (PTR) dataset is publicly available, which comprises 800 complete 3D models of pulmonary airways, arteries, and veins, as well as the synthetic disconnected data. Our code and data are available at https://github.com/M3DV/pulmonary-tree-repairing.