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Early mobilization is a structured protocol designed to facilitate motor recovery in intensive care unit (ICU) patients with ICU-acquired weakness. This process is typically implemented by an interdisciplinary team of nurses, physical therapists, and other healthcare professionals. However, its application is often constrained by the patients' critical conditions, limited mobility, and the challenges of coordinating care within resource-intensive ICU environments. In this study, we developed a patient-centered virtual reality (VR) exergame through an interdisciplinary design process involving clinicians and therapists, tailored to the constraints of critical care. The exergame incorporates progressive mobility levels that mirror early mobilization practices, and includes an embodied avatar to provide guidance and motivation. Using Meta Quest 3 body tracking, the system captures and visualizes patients' movements, thereby providing motivational engagement and quantifiable mobility metrics. We evaluated the exergame in two stages: a dual-user study involving healthy participants and healthcare professionals or students (N = 13), and a subsequent study with cardiothoracic ICU patients

We introduce CRIMSON, a clinically grounded evaluation framework for chest X-ray report generation that assesses reports based on diagnostic correctness, contextual relevance, and patient safety. Unlike prior metrics, CRIMSON incorporates full clinical context, including patient age, indication, and guideline-based decision rules, and prevents normal or clinically insignificant findings from exerting disproportionate influence on the overall score. The framework categorizes errors into a comprehensive taxonomy covering false findings, missing findings, and eight attribute-level errors (e.g., location, severity, measurement, and diagnostic overinterpretation). Each finding is assigned a clinical significance level (urgent, actionable non-urgent, non-actionable, or expected/benign), based on a guideline developed in collaboration with attending cardiothoracic radiologists, enabling severity-aware weighting that prioritizes clinically consequential mistakes over benign discrepancies. CRIMSON is validated through strong alignment with clinically significant error counts annotated by six board-certified radiologists in ReXVal (Kendalls tau = 0.61-0.71; Pearsons r = 0.71-0.84), and throu

Robust anatomical segmentation of chest X-rays (CXRs) remains challenging due to the scarcity of comprehensive annotations and the substantial variability of real-world acquisition conditions. We propose AnyCXR, a unified framework that enables generalizable multi-organ segmentation across arbitrary CXR projection angles using only synthetic supervision. The method combines a Multi-stage Domain Randomization (MSDR) engine, which generates over 100,000 anatomically faithful and highly diverse synthetic radiographs from 3D CT volumes, with a Conditional Joint Annotation Regularization (CAR) learning strategy that leverages partial and imperfect labels by enforcing anatomical consistency in a latent space. Trained entirely on synthetic data, AnyCXR achieves strong zero-shot generalization on multiple real-world datasets, providing accurate delineation of 54 anatomical structures in PA, lateral, and oblique views. The resulting segmentation maps support downstream clinical tasks, including automated cardiothoracic ratio estimation, spine curvature assessment, and disease classification, where the incorporation of anatomical priors improves diagnostic performance. These results demonstr

Deep learning models have revolutionized medical imaging and diagnostics, yet their opaque nature poses challenges for clinical adoption and trust. Amongst approaches to improve model interpretability, concept-based explanations aim to provide concise and human-understandable explanations of any arbitrary classifier. However, such methods usually require a large amount of manually collected data with concept annotation, which is often scarce in the medical domain. In this paper, we propose Conceptual Counterfactual Explanations for Chest X-ray (CoCoX), which leverages the joint embedding space of an existing vision-language model (VLM) to explain black-box classifier outcomes without the need for annotated datasets. Specifically, we utilize textual concepts derived from chest radiography reports and a pre-trained chest radiography-based VLM to explain three common cardiothoracic pathologies. We demonstrate that the explanations generated by our method are semantically meaningful and faithful to underlying pathologies.

Generative AI systems such as ChatGPT and Claude are built upon language models that are typically evaluated for accuracy on curated benchmark datasets. Such evaluation paradigms measure predictive and reasoning capabilities of language models but do not assess if they can provide information that is useful to people. In this paper, we take some initial steps in developing an evaluation paradigm that centers human understanding and decision-making. We study the utility of generative AI systems in supporting people in a concrete task - making sense of clinical reports and imagery in order to make a clinical decision. We conducted a formative need-finding study in which participants discussed chest computed tomography (CT) scans and associated radiology reports of a fictitious close relative with a cardiothoracic radiologist. Using thematic analysis of the conversation between participants and medical experts, we identified commonly occurring themes across interactions, including clarifying medical terminology, locating the problems mentioned in the report in the scanned image, understanding disease prognosis, discussing the next diagnostic steps, and comparing treatment options. Bas

Self-supervised foundation models have recently been successfully extended to encode three-dimensional (3D) computed tomography (CT) images, with excellent performance across several downstream tasks, such as intracranial hemorrhage detection and lung cancer risk forecasting. However, as self-supervised models learn from complex data distributions, questions arise concerning whether these embeddings capture demographic information, such as age, sex, or race. Using the National Lung Screening Trial (NLST) dataset, which contains 3D CT images and demographic data, we evaluated a range of classifiers: softmax regression, linear regression, linear support vector machine, random forest, and decision tree, to predict sex, race, and age of the patients in the images. Our results indicate that the embeddings effectively encoded age and sex information, with a linear regression model achieving a root mean square error (RMSE) of 3.8 years for age prediction and a softmax regression model attaining an AUC of 0.998 for sex classification. Race prediction was less effective, with an AUC of 0.878. These findings suggest a detailed exploration into the information encoded in self-supervised learn

Collaborative planning for congenital heart diseases typically involves creating physical heart models through 3D printing, which are then examined by both surgeons and cardiologists. Recent developments in mobile augmented reality (AR) technologies have presented a viable alternative, known for their ease of use and portability. However, there is still a lack of research examining the utilization of multi-user mobile AR environments to support collaborative planning for cardiovascular surgeries. We created ARCollab, an iOS AR app designed for enabling multiple surgeons and cardiologists to interact with a patient's 3D heart model in a shared environment. ARCollab enables surgeons and cardiologists to import heart models, manipulate them through gestures and collaborate with other users, eliminating the need for fabricating physical heart models. Our evaluation of ARCollab's usability and usefulness in enhancing collaboration, conducted with three cardiothoracic surgeons and two cardiologists, marks the first human evaluation of a multi-user mobile AR tool for surgical planning. ARCollab is open-source, available at https://github.com/poloclub/arcollab.

Advanced surgical procedures for congenital heart diseases (CHDs) require precise planning before the surgeries. The conventional approach utilizes 3D-printing and cutting physical heart models, which is a time and resource intensive process. While rapid advances in augmented reality (AR) technologies have the potential to streamline surgical planning, there is limited research that evaluates such AR approaches with medical experts. This paper presents an evaluation with 6 experts, 4 cardiothoracic surgeons, and 2 cardiologists, from Children's Healthcare of Atlanta (CHOA) Heart Center to validate the usability and technical innovations of CardiacAR, a prototype mobile AR surgical planning application. Potential future improvements based on user feedback are also proposed to further improve the design of CardiacAR and broaden its access.

We propose a BlackBox Counterfactual Explainer, designed to explain image classification models for medical applications. Classical approaches (e.g., saliency maps) that assess feature importance do not explain "how" imaging features in important anatomical regions are relevant to the classification decision. Our framework explains the decision for a target class by gradually "exaggerating" the semantic effect of the class in a query image. We adopted a Generative Adversarial Network (GAN) to generate a progressive set of perturbations to a query image, such that the classification decision changes from its original class to its negation. We used counterfactual explanations from our framework to audit a classifier trained on a chest x-ray dataset with multiple labels. We proposed clinically-relevant quantitative metrics such as cardiothoracic ratio and the score of a healthy costophrenic recess to evaluate our explanations. We conducted a human-grounded experiment with diagnostic radiology residents to compare different styles of explanations (no explanation, saliency map, cycleGAN explanation, and our counterfactual explanation) by evaluating different aspects of explanations: (1)

An important step for any causal inference study design is understanding the distribution of the treated and control subjects in terms of measured baseline covariates. However, not all baseline variation is equally important. In the observational context, balancing on baseline variation summarized in a propensity score can help reduce bias due to self-selection. In both observational and experimental studies, controlling baseline variation associated with the expected outcomes can help increase the precision of causal effect estimates. We propose a set of visualizations which decompose the space of measured covariates into the different types of baseline variation important to the study design. These ``assignment-control plots'' and variations thereof visually illustrate core concepts of causal inference and suggest new directions for methodological research on study design. As a practical demonstration, we illustrate one application of assignment-control plots to a study of cardiothoracic surgery. While the family of visualization tools for studies of causality is relatively sparse, simple visual tools can be an asset to education, application, and methods development.

Chest radiography (CXR) is the most widely-used thoracic clinical imaging modality and is crucial for guiding the management of cardiothoracic conditions. The detection of specific CXR findings has been the main focus of several artificial intelligence (AI) systems. However, the wide range of possible CXR abnormalities makes it impractical to build specific systems to detect every possible condition. In this work, we developed and evaluated an AI system to classify CXRs as normal or abnormal. For development, we used a de-identified dataset of 248,445 patients from a multi-city hospital network in India. To assess generalizability, we evaluated our system using 6 international datasets from India, China, and the United States. Of these datasets, 4 focused on diseases that the AI was not trained to detect: 2 datasets with tuberculosis and 2 datasets with coronavirus disease 2019. Our results suggest that the AI system generalizes to new patient populations and abnormalities. In a simulated workflow where the AI system prioritized abnormal cases, the turnaround time for abnormal cases reduced by 7-28%. These results represent an important step towards evaluating whether AI can be saf

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Scientists have created twisted laser beams that interact differently with right-handed and left-handed molecules, revealing their identity through the fragments they produce。 The approach could provide a faster, simpler, and more sensitive way to analyze important molecules used in chemistry and pharmaceuticals

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Engineers have transformed a notoriously brittle cobalt-aluminum compound into a material that is both extremely strong and capable of bending without breaking。 Their nanoscale design produced a yield strength about six to 10 times greater than high-strength structural steel while sustaining substantial deformation at room temperature。 The approach