搜索结果：Progress in pediatric cardiology

Biomedical text embeddings have primarily been developed using research literature from PubMed, yet clinical cardiology practice relies heavily on procedural knowledge and specialized terminology found in comprehensive textbooks rather than research abstracts. This research practice gap limits the effectiveness of existing embedding models for clinical applications incardiology. This study trained CardioEmbed, a domain-specialized embedding model based on Qwen3-Embedding-8B, using contrastive learning on a curated corpus of seven comprehensive cardiology textbooks totaling approximately 150,000 sentences after deduplication. The model employs InfoNCE loss with in-batch negatives and achieves 99.60% retrieval accuracy on cardiac-specific semantic retrieval tasks, a +15.94 percentage point improvement over MedTE, the current state-of-the-art medical embedding model. On MTEB medical benchmarks, the model obtained BIOSSES 0.77 Spearman and SciFact 0.61 NDCG@10, indicating competitive performance on related biomedical domains. Domain-specialized training on comprehensive clinical textbooks yields near-perfect cardiology retrieval (99.60% Acc@1), improving over MedTE by +15.94 percentage

Computerized gait analysis (CGA) serves as an essential diagnostic tool for evaluating neuromuscular, musculoskeletal, and neurological disorders in children, from cerebral palsy to muscular dystrophy. By enabling objective and comprehensive gait analysis, CGA supports timely clinical interventions that can significantly improve pediatric mobility outcomes and quality of life. Yet pediatric gait analysis introduces unique design considerations often underexplored in existing CGA research, as children's ongoing development shapes assessment requirements. To understand how CGA technologies can be designed for pediatric care, we conducted a qualitative study with 12 pediatric clinicians and one system designer who routinely work with CGA. Participants identified child-specific challenges including managing heightened sensory sensitivities to wearable devices, accommodating body proportions in sensor placement and calibration, and maintaining patient engagement during data collection. Clinicians also articulated needs for workflow adaptations and expressed interest in extending gait analysis beyond controlled laboratory settings into naturalistic environments such as playgrounds and sc

Pediatric medical imaging presents unique challenges due to significant anatomical and developmental differences compared to adults. Direct application of segmentation models trained on adult data often yields suboptimal performance, particularly for small or rapidly evolving structures. To address these challenges, several strategies leveraging the nnU-Net framework have been proposed, differing along four key axes: (i) the fingerprint dataset (adult, pediatric, or a combination thereof) from which the Training Plan -including the network architecture-is derived; (ii) the Learning Set (adult, pediatric, or mixed), (iii) Data Augmentation parameters, and (iv) the Transfer learning method (finetuning versus continual learning). In this work, we introduce PSAT (Pediatric Segmentation Approaches via Adult Augmentations and Transfer learning), a systematic study that investigates the impact of these axes on segmentation performance. We benchmark the derived strategies on two pediatric CT datasets and compare them with state-of-theart methods, including a commercial radiotherapy solution. PSAT highlights key pitfalls and provides actionable insights for improving pediatric segmentation.

Background: Pediatric dental disease remains one of the most prevalent and inequitable chronic health conditions worldwide. Although strong epidemiological evidence links oral health outcomes to socio-economic and demographic determinants, most artificial intelligence (AI) applications in dentistry rely on image-based diagnosis and black-box prediction models, limiting transparency and ethical applicability in pediatric populations. Objective: This study aimed to develop and evaluate an explainable machine learning framework for pediatric dental risk stratification that prioritizes interpretability, calibration, and ethical deployment over maximal predictive accuracy. Methods: A supervised machine learning model was trained using population-level pediatric data including age, income-to-poverty ratio, race/ethnicity, gender, and medical history. Model performance was assessed using receiver operating characteristic (ROC) analysis and calibration curves. Explainability was achieved using SHapley Additive exPlanations (SHAP) to provide global and individual-level interpretation of predictions. Results: The model achieved modest discrimination (AUC = 0.61) with conservative calibration

Reinforcement learning with verifiable rewards (RLVR) has recently advanced the reasoning capabilities of large language models (LLMs). While prior work has emphasized algorithmic design, data curation, and reward shaping, we investigate RLVR from a sample-centric perspective and introduce LPPO (Learning-Progress and Prefix-guided Optimization), a framework of progressive optimization techniques. Our work addresses a critical question: how to best leverage a small set of trusted, high-quality demonstrations, rather than simply scaling up data volume. First, motivated by how hints aid human problem-solving, we propose prefix-guided sampling, an online data augmentation method that incorporates partial solution prefixes from expert demonstrations to guide the policy, particularly for challenging instances. Second, inspired by how humans focus on important questions aligned with their current capabilities, we introduce learning-progress weighting, a dynamic strategy that adjusts each training sample's influence based on model progression. We estimate sample-level learning progress via an exponential moving average of per-sample pass rates, promoting samples that foster learning and de

Pulmonary arterial hypertension (PAH) is a progressive cardiopulmonary disease that leads to increased pulmonary pressures, vascular remodeling, and eventual right ventricular (RV) failure. Pediatric PAH remains understudied due to limited data and the lack of targeted diagnostic and therapeutic strategies. In this study, we developed and calibrated multi-scale, patient-specific cardiovascular models for four pediatric PAH patients using longitudinal MRI and catheterization data collected approximately two years apart. Using the CRIMSON simulation framework, we coupled three-dimensional fluid-structure interaction (FSI) models of the pulmonary arteries with zero-dimensional (0D) lumped-parameter heart and Windkessel models to simulate patient hemodynamics. An automated Python-based optimizer was developed to calibrate boundary conditions by minimizing discrepancies between simulated and clinical metrics, reducing calibration time from weeks to days. Model-derived metrics such as arterial stiffness, pulse wave velocity, resistance, and compliance were found to align with clinical indicators of disease severity and progression. Our findings demonstrate that computational modeling can

Pediatric chest X-ray imaging is essential for early diagnosis, particularly in low-resource settings where advanced imaging modalities are often inaccessible. Low-dose protocols reduce radiation exposure in children but introduce substantial noise that can obscure critical anatomical details. Conventional denoising methods often degrade fine details, compromising diagnostic accuracy. In this paper, we present SharpXR, a structure-aware dual-decoder U-Net designed to denoise low-dose pediatric X-rays while preserving diagnostically relevant features. SharpXR combines a Laplacian-guided edge-preserving decoder with a learnable fusion module that adaptively balances noise suppression and structural detail retention. To address the scarcity of paired training data, we simulate realistic Poisson-Gaussian noise on the Pediatric Pneumonia Chest X-ray dataset. SharpXR outperforms state-of-the-art baselines across all evaluation metrics while maintaining computational efficiency suitable for resource-constrained settings. SharpXR-denoised images improved downstream pneumonia classification accuracy from 88.8% to 92.5%, underscoring its diagnostic value in low-resource pediatric care.

Demyelinating disorders of the central nervous system may have multiple causes, the most common are infections, autoimmune responses, genetic or vascular etiology. Demyelination lesions are characterized by areas were the myelin sheath of the nerve fibers are broken or destroyed. Among autoimmune disorders, Multiple Sclerosis (MS) is the most well-known Among these disorders, Multiple Sclerosis (MS) is the most well-known and aggressive form. Acute Disseminated Encephalomyelitis (ADEM) is another type of demyelinating disease, typically with a better prognosis. Magnetic Resonance Imaging (MRI) is widely used for diagnosing and monitoring disease progression by detecting lesions. While both adults and children can be affected, there is a significant lack of publicly available datasets for pediatric cases and demyelinating disorders beyond MS. This study introduces, for the first time, a publicly available pediatric dataset for demyelinating lesion segmentation. The dataset comprises MRI scans from 13 pediatric patients diagnosed with demyelinating disorders, including 3 with ADEM. In addition to lesion segmentation masks, the dataset includes extensive patient metadata, such as diag

Graph Retrieval-Augmented Generation (GraphRAG) has emerged as a promising paradigm that organizes external knowledge into structured graphs of entities and relations, enabling large language models (LLMs) to perform complex reasoning beyond text-chunk retrieval. Recent advances have integrated reinforcement learning (RL) into agentic GraphRAG approaches, enabling iterative interactions with knowledge graphs during training. However, existing RL-based methods suffer from two key limitations: (1) they primarily depend on semantic similarity for retrieval, often overlooking the underlying graph topology, and (2) they rely on sparse, outcome-level rewards that fail to capture the quality of intermediate retrieval steps and their dependencies. To address these limitations, we propose HyperGraphPro, a progress-aware agentic framework for graph-based retrieval and multi-step reasoning. HyperGraphPro introduces a structure-aware hypergraph retrieval mechanism that jointly considers semantic relevance and graph connectivity, promoting coherent traversal along multi-hop reasoning paths. Furthermore, we design a progress-based stepwise policy optimization that provides dense learning signals

Heart diseases remain a leading cause of morbidity and mortality worldwide, necessitating accurate and trustworthy differential diagnosis. However, existing artificial intelligence-based diagnostic methods are often limited by insufficient cardiology knowledge, inadequate support for complex reasoning, and poor interpretability. Here we present HeartAgent, a cardiology-specific agent system designed to support a reliable and explainable differential diagnosis. HeartAgent integrates customized tools and curated data resources and orchestrates multiple specialized sub-agents to perform complex reasoning while generating transparent reasoning trajectories and verifiable supporting references. Evaluated on the MIMIC dataset and a private electronic health records cohort, HeartAgent achieved over 36% and 20% improvements over established comparative methods, in top-3 diagnostic accuracy, respectively. Additionally, clinicians assisted by HeartAgent demonstrated gains of 26.9% in diagnostic accuracy and 22.7% in explanatory quality compared with unaided experts. These results demonstrate that HeartAgent provides reliable, explainable, and clinically actionable decision support for cardio

Recent advancements in deep learning for Medical Artificial Intelligence have demonstrated that models can match the diagnostic performance of clinical experts in adult chest X-ray (CXR) interpretation. However, their application in the pediatric context remains limited due to the scarcity of large annotated pediatric image datasets. Additionally, significant challenges arise from the substantial variability in pediatric CXR images across different hospitals and the diverse age range of patients from 0 to 18 years. To address these challenges, we propose SCC, a novel approach that combines transfer learning with self-supervised contrastive learning, augmented by an unsupervised contrast enhancement technique. Transfer learning from a well-trained adult CXR model mitigates issues related to the scarcity of pediatric training data. Contrastive learning with contrast enhancement focuses on the lungs, reducing the impact of image variations and producing high-quality embeddings across diverse pediatric CXR images. We train SCC on one pediatric CXR dataset and evaluate its performance on two other pediatric datasets from different sources. Our results show that SCC's out-of-distribution

Electronic health records contain rich textual data which possess critical predictive information for machine-learning based diagnostic aids. However many traditional machine learning methods fail to simultaneously integrate both vector space data and text. We present a supervised method using Laplacian eigenmaps to augment existing machine-learning methods with low-dimensional representations of textual predictors which preserve the local similarities. The proposed implementation performs alternating optimization using gradient descent. For the evaluation we applied our method to over 2,000 patient records from a large single-center pediatric cardiology practice to predict if patients were diagnosed with cardiac disease. Our method was compared with latent semantic indexing, latent Dirichlet allocation, and local Fisher discriminant analysis. The results were assessed using AUC, MCC, specificity, and sensitivity. Results indicate supervised Laplacian eigenmaps was the highest performing method in our study, achieving 0.782 and 0.374 for AUC and MCC respectively. SLE showed an increase in 8.16% in AUC and 20.6% in MCC over the baseline which excluded textual data and a 2.69% and 5.

Pediatric critical care is a dynamic, high-stakes process involving constant monitoring and adjustments in life-saving treatments. Modeling these interventions is crucial for effective decision support. To address the challenges of high complexity and data scarcity in pediatric Extracorporeal Membrane Oxygenation (ECMO), we frame clinical decision-making as learning to act from trajectories, i.e., imitation learning that learns action models from observational data, with a key feature that actions are not directly observed. We consider TabPFN, a recent transformer-based approach for tabular data, and traditional baselines including XGBoost and Multi-Layer Perceptrons(MLPs) on real-world pediatric ECMO data to learn the action models. We find that the TabPFN-based approach consistently outperforms these classical baselines, supporting its use as a strong clinician-behavior baseline for pediatric ECMO decision support.

Skull-stripping is the removal of background and non-brain anatomical features from brain images. While many skull-stripping tools exist, few target pediatric populations. With the emergence of multi-institutional pediatric data acquisition efforts to broaden the understanding of perinatal brain development, it is essential to develop robust and well-tested tools ready for the relevant data processing. However, the broad range of neuroanatomical variation in the developing brain, combined with additional challenges such as high motion levels, as well as shoulder and chest signal in the images, leaves many adult-specific tools ill-suited for pediatric skull-stripping. Building on an existing framework for robust and accurate skull-stripping, we propose developmental SynthStrip (d-SynthStrip), a skull-stripping model tailored to pediatric images. This framework exposes networks to highly variable images synthesized from label maps. Our model substantially outperforms pediatric baselines across scan types and age cohorts. In addition, the <1-minute runtime of our tool compares favorably to the fastest baselines. We distribute our model at https://w3id.org/synthstrip.

Large language models (LLMs) and vision-augmented LLMs (VLMs) have significantly advanced medical informatics, diagnostics, and decision support. However, these models exhibit systematic biases, particularly age bias, compromising their reliability and equity. This is evident in their poorer performance on pediatric-focused text and visual question-answering tasks. This bias reflects a broader imbalance in medical research, where pediatric studies receive less funding and representation despite the significant disease burden in children. To address these issues, a new comprehensive multi-modal pediatric question-answering benchmark, PediatricsMQA, has been introduced. It consists of 3,417 text-based multiple-choice questions (MCQs) covering 131 pediatric topics across seven developmental stages (prenatal to adolescent) and 2,067 vision-based MCQs using 634 pediatric images from 67 imaging modalities and 256 anatomical regions. The dataset was developed using a hybrid manual-automatic pipeline, incorporating peer-reviewed pediatric literature, validated question banks, existing benchmarks, and existing QA resources. Evaluating state-of-the-art open models, we find dramatic performan

Pediatric bone age prediction is a crucial task in clinical practice that can help diagnose endocrine disorders and provide insight into a child's growth and development. However, conventional bone age prediction methods are often labor-intensive and require specialized radiological expertise. This paper presents a Deep Learning (DL)-based approach to pediatric bone age prediction using EfficientNet with Additive Attention, a state-of-the-art neural network architecture for image classification and regression tasks. The method utilizes over 12,000 X-ray images from the RSNA bone age dataset. It involves image preprocessing, transforming them into three-channel images, and training a Convolutional Neural Network (CNN) to automatically learn the features of hand bone images. This approach provides a more effective and accurate solution for predicting bone age, which is critical in diagnosing pediatric endocrine diseases. This work uses two variations of the EfficientNet model (B0 and B4), where EfficientNetB4 is also finetuned with the Additive Attention mechanism. These three models predict the age for the original age, and their comparison is shown in curves. The predicted ages dep

Virtual reality (VR) is increasingly used across psychology, from research and assessment to counseling, psychological treatment, and psychotherapy, with growing applications for children and adolescents. In these contexts, VR is often treated as a relatively neutral delivery medium. This assumption may be misleading. Most consumer head-mounted displays (HMDs) have been designed primarily for adult anthropometry, including adult interpupillary distance (IPD) ranges. As a result, some children may be excluded from participation or may receive a systematically degraded perceptual experience because the device cannot be adequately aligned to their visual anatomy. This paper argues that IPD constraints in consumer VR headsets represent an underrecognized methodological and clinical problem in pediatric psychology and psychotherapy. If headset fit affects visual comfort, depth perception, attentional load, cybersickness, willingness to remain in the simulation, and sense of presence, it may also influence engagement, emotional processing, dropout, and treatment response. The headset may therefore function as a selection mechanism, shaping who is included in studies, who can tolerate int

The rapidly increasing volume of electronic health record (EHR) data underscores a pressing need to unlock biomedical knowledge from unstructured clinical texts to support advancements in data-driven clinical systems, including patient diagnosis, disease progression monitoring, treatment effects assessment, prediction of future clinical events, etc. While contextualized language models have demonstrated impressive performance improvements for named entity recognition (NER) systems in English corpora, there remains a scarcity of research focused on clinical texts in low-resource languages. To bridge this gap, our study aims to develop multiple deep contextual embedding models to enhance clinical NER in the cardiology domain, as part of the BioASQ MultiCardioNER shared task. We explore the effectiveness of different monolingual and multilingual BERT-based models, trained on general domain text, for extracting disease and medication mentions from clinical case reports written in English, Spanish, and Italian. We achieved an F1-score of 77.88% on Spanish Diseases Recognition (SDR), 92.09% on Spanish Medications Recognition (SMR), 91.74% on English Medications Recognition (EMR), and 88.

Cardiovascular diseases are becoming increasingly prevalent in modern society, with a profound impact on global health and well-being. These Cardiovascular disorders are complex and multifactorial, influenced by genetic predispositions, lifestyle choices, and diverse socioeconomic and clinical factors. Information about these interrelated factors is dispersed across multiple types of textual data, including patient narratives, medical records, and scientific literature. Natural language processing (NLP) has emerged as a powerful approach for analysing such unstructured data, enabling healthcare professionals and researchers to gain deeper insights that may transform the diagnosis, treatment, and prevention of cardiac disorders. This review provides a comprehensive overview of NLP research in cardiology from 2014 to 2025. We systematically searched six literature databases for studies describing NLP applications across a range of cardiovascular diseases. After a rigorous screening process, we identified 265 relevant articles. Each study was analysed across multiple dimensions, including NLP paradigms, cardiology-related tasks, disease types, and data sources. Our findings reveal sub