Prognostics

This study explores the use of deep learning and explainable artificial intelligence to diagnose hepatocellular carcinoma (HCC) and define effective biomarkers across five different stages of disease development using a transcriptomic biomarker HCC dataset constructed via semi-supervised learning from three source datasets. Several deep learning experiments were conducted with different feature extraction techniques and gene sets to identify the most effective features for training high-accuracy models with minimal loss. The best-performing model, using 15 selected genes with the SelectKBest algorithm, achieved 90.74% accuracy, while the model with the lowest recorded loss of 0.3187 was obtained using 20 selected genes. To address the issue of class imbalance in the dataset, a weighted training approach was conducted, and for model transparency and interpretability a SHAP-based XAI analysis provided insights into the model's decision-making, consistently finding DNAJB14 as the most influential gene. Functional validation in this study has provided compelling evidence that DNAJB14 plays an important role in the adverse properties of HCC and that its inhibition effectively reverses tumour cell migration, invasion, colony and sphere formation. The main limitation of this study is the dataset's class imbalance, and while weighted training helped mitigate this, further research and additional data are needed to guarantee model generalizability. Future studies should also explore the influence of genetic variations, environmental factors, and clinical differences on model performance across diverse populations.

Post-treatment MRI in patients with glioma provides serial observations for updating patient-specific tumor-state proxy estimates, but variable appearances and trajectories complicate forecasting. We formulate forecasting as an observation-aware digital-twin update in which an intermediate observation anchors the patient-specific state. Among 203 patients and 594 follow-up time points, a predefined no-new-treatment criterion retained 120 of 236 candidate triplets, split into 81/24/15 training/validation/test triplets at the patient level. Each time point was represented by a continuous voxel-wise tumor-state proxy map in [0,1] derived from MRI lesion labels. A SegMamba-based single-step forecaster predicted update proposals from multimodal source-state tensors. Observation-Anchored Selective Assimilation (OASA) retained the observed intermediate proxy as the state anchor and selectively applied updates through a validation-selected tiered case-level rule and voxel-wise soft gate. We compared initial-scan forecasting, rollout without assimilation, latest-observation persistence, direct prediction, OASA, OASA + calibration, and morphological dilation. Checkpoints, OASA rules, and calibration thresholds were selected using validation data only. Across three seeds on 15 held-out test triplets, OASA maintained Dice at $\tau$ = 0.2 comparable to persistence (0.6071 $\pm$ 0.0025 vs. 0.6070) while yielding numerically higher Dice at $\tau$ = 0.5 (0.4269 $\pm$ 0.0079 vs. 0.3981), with a small RMSE increase. Calibration increased Dice at $\tau$ = 0.2 to 0.6178 $\pm$ 0.0025, increased false-positive (FP) support (11,836$\rightarrow$18,663), and reduced false-negative (FN) support (22,107$\rightarrow$17,536). This reflects near-threshold support calibration rather than improved biological predictive capability. Code is publicly available at https://github.com/jsudg436/longitudinal-proxy-forecasting.

Clinical prediction models are often developed as if the outcome of interest were cleanly observed for every patient. This assumption fails when treatment decisions make the clinically relevant outcome permanently unobservable. As a case study of this problem, we consider post-cardiac-arrest neurological prognostication using a cohort of 2,497 patients, including 1,429 patients whose outcomes were rendered indeterminate by treatment decisions. These patients with indeterminate outcomes were reviewed by independent clinical experts, who provided their guesses of counterfactual outcomes about what would have happened to the patients. We refer to these patients as uncertain cases. We also have patients for whom we observe their clinically relevant outcomes; we refer to these patients as certain cases. We propose a framework for evaluating prediction models that explicitly splits the evaluation between certain and uncertain cases. Here, we cannot easily evaluate both types of cases in a uniform manner as the available target labels differ. We then propose a simple prediction model that uses target labels from both certain and uncertain cases in a manner that allows us to trade off between them. Across the proposed neural model and a collection of tabular baselines, models with similar certain-case AUROC can nevertheless differ substantially in both certain-case Brier score and their probability estimates for uncertain cases. Improving alignment with target labels of uncertain cases for our proposed model generally comes at the cost of worse accuracy on certain cases, highlighting an explicit tradeoff that standard evaluation conceals. These results show that when treatment decisions determine whether clinically meaningful outcomes remain observable, conventional evaluation metrics can miss important failure modes in the very patients for whom prognostic support matters most.

In modern industry, keeping complex systems reliable, safe, and efficient hinges on Prognostics and Health Management (PHM). Machine Learning (ML) has largely driven advancements in diagnostics and prognostics, yet purely data-driven models face inherent limitations, such as poor generalization, an inability to infer causal relationships, and a lack of interpretability. Physics-Informed Machine Learning (PIML) helps mitigate these limitations by incorporating prior physical knowledge directly into the ML pipeline, thereby fostering growing interest in its application to PHM. This work investigates how PIML is being leveraged in the context of PHM through a systematic literature review of 212 studies. The review introduces a four-class classification scheme, consisting of observational bias, inductive bias, learning bias, and hybrid approaches, and further categorizes studies by PHM task. Across all four classes, the reviewed studies consistently demonstrate improved predictive performance over conventional baselines across a broad range of assets, although the literature is heavily skewed toward lithium-ion batteries and bearings, and dominated by problem-specific solutions. Overall, the review indicates that physics-informed approaches already provide tangible benefits, whereas claims of improvements concerning some of the aforementioned limitations lack sufficient supporting evidence. Future research should prioritize transferable design patterns, benchmarks comparing integration strategies, and uncertainty-aware models that are lightweight and robust enough for online deployment in real-world settings.

Cardiologists interpret electrocardiograms by localizing waveform components, measuring rhythm and interval patterns, and translating these structured observations into diagnostic evidence. Whether this expert reading process can serve as an effective prior for ECG agents remains unclear. To address this question, we introduce LuminaECG, a clinically structured ECG reasoning framework that reformulates ECG interpretation as measurement-grounded visual reading. ECG signals are rendered on standard electrocardiographic grid paper to preserve the spatial and scale cues used in clinical reading. P-wave, QRS-complex, and T-wave boundaries are explicitly delineated, and color-coded segmentation decomposes the waveform into discrete visual measurement primitives. A general 2B vision-language backbone is then trained with low-rank supervised fine-tuning to associate these primitives with diagnostic reasoning, without architectural modification. Across open, proprietary, and ECG-specialist zero-shot baselines, LuminaECG improves both waveform measurement and diagnostic recovery. It reaches a clinically meaningful reader tier on the CODE-test benchmark, transfers across geographically diverse ECG datasets without retraining, and generates reports whose structure contains an emergent prognostic signal. These findings suggest that effective ECG agents require not only larger models, but supervision that preserves the alignment between measurable waveform evidence and clinical knowledge.

Machine learning models achieve strong predictive accuracy for 90-day outcome prediction in acute ischaemic stroke, yet clinical adoption is limited by the misalignment of model explanations with clinicians' reasoning. Motivated by a clinician user study calling for clinical guideline-aligned cut-offs, we ask whether continuous predictors can be replaced by clinically informed categorical encodings without sacrificing performance. On a multi-centre European registry stratified into three treatment cohorts, we compare standard and fully categorised gradient-boosted models, the latter using stroke guideline-aligned, treatment-specific thresholds. The fully categorised models are statistically indistinguishable from their continuous counterparts in two of the treatment cohorts, with a significant drop in predictive accuracy in one cohort. Global feature importance rankings remain consistent, suggesting that discretising continuous predictors into guideline-based categories preserves the core hierarchy of prognostic factors across all treatment groups. Guideline-based categorisation is thus a viable design choice for stroke-outcome models.

Survival analysis is an established framework for analyzing time-to-event data, yet many clinical machine learning studies still binarize the outcome before model training. This practice excludes censored patients, collapses temporal information into a single threshold, and can affect which features are selected as prognostically relevant. We examine the cost of this binarization in the context of Bayesian network (BN) feature selection, using two recent publications as case studies: one that applies BN-based feature selection to a head-and-neck cancer cohort and a second surgical cohort study that, while not BN-based, likewise binarizes its survival endpoint. We replace the binary scoring function with the Cox partial log-likelihood for feature-to-outcome edges, a modification we call the Survival-Aware Bayesian network, and recover prognostic features that binarization misses. Our ablation experiment confirms that the improvement is driven by the time-to-event scoring formulation rather than by retaining more patients. The results generalize across five endpoint-cohort combinations in head-and-neck cancer and extend to three further cancer types (breast, colorectal, and kidney). We propose that clinical studies with survival outcomes should use time-to-event methods by default, as binarization discards the prognostic signal retained by survival analysis.

Time-to-event modeling provides a systematic framework for estimating time-dependent failure risk, reliability, and remaining useful life (RUL) from longitudinal condition monitoring data. However, applying these models to distributed prognostics remains challenging because sensor trajectories and failure-time records are often stored across organizations or operational sites and cannot be centrally pooled due to privacy or proprietary constraints. Moreover, the classical Cox proportional hazards model relies on a nonseparable partial likelihood involving global risk sets, making direct optimization difficult under standard federated learning protocols. This paper presents a federated longitudinal-survival modeling framework for collaborative system failure prognostics. The proposed framework combines longitudinal sensor representation learning with a client-separable discrete-time hazard objective, enabling multiple clients to collaboratively train a prognostic model without sharing raw sensor measurements or individual failure records. Time-dependent representations extracted from multivariate sensor histories are used to estimate interval-specific failure hazards, reliability curves, and system RUL. Experiments on the four C-MAPSS turbofan engine degradation subsets under simulated decentralized settings demonstrate that the proposed framework consistently improves prognostic performance over isolated local training while maintaining performance comparable to centralized training across heterogeneous operating conditions and failure modes. These results demonstrate the potential of federated longitudinal-survival modeling for collaborative, data-aware condition monitoring and system failure prognostics.

Dysphagia is a debilitating late effect of head and neck cancer (HNC) treatment, yet timely identification of at-risk patients remains challenging in survivorship care. Definitive assessment relies on videofluoroscopic imaging, as captured by the Dynamic Imaging Grade of Swallowing Toxicity (CTCAE-DIGEST), which, while validated, requires specialized equipment, trained personnel, and significant patient burden, limiting its routine use in surveillance. Patient-reported outcomes (PROs), by contrast, are low-cost, scalable, and easily collected at any clinical encounter, making them an attractive alternative signal for identifying patients who may warrant further evaluation. However, a clear clinical framework for translating PRO responses into actionable interventions is still evolving. In particular, uncertainty remains regarding when a patient's self-reported symptom burden should prompt escalation of care. This study addresses this gap by formulating a single-visit PRO-clinical prediction framework and introducing a clinically interpretable two-stage stacking model to predict swallowing impairment risk using PRO responses and structured clinical variables, without requiring videofluoroscopic imaging. The proposed framework quantifies the independent contributions of patient-reported symptoms and clinical factors within a unified and interpretable risk assessment model. Our findings demonstrate that individual MDADI responses contain predictive information beyond that captured by composite or global summary scores, while interpretability analyses reveal symptom patterns and clinical risk factors associated with swallowing impairment. Together, these results support the use of structured PRO-clinical integration as a practical, imaging-free approach for dysphagia risk stratification in HNC survivorship.

Objective: To develop a low-cost automated cataract severity classification system operating on standard consumer-grade colour photographs of the eye, without specialised ophthalmic hardware. Methods: A hybrid framework was designed that fuses deep features from a Convolutional Neural Network (CNN) with five handcrafted Grey-Level Co-occurrence Matrix (GLCM) and intensity descriptors - mean intensity, uniformity, standard deviation, contrast, and energy - extracted from a Hough-circle-localised pupil Region of Interest (ROI). A multi-class Support Vector Machine (SVM) with Radial Basis Function (RBF) kernel classifies each image into one of four severity grades: normal, immature, mature, or hypermature cataract. Results: The proposed fused system achieved 95.0% accuracy, 93.8% sensitivity, and 96.1% specificity on an ophthalmologist-labelled test set drawn from 300 images (75 per class) collected at an ophthalmology clinic, outperforming texture-only (88.5%) and CNN-only (91.3%) baselines and surpassing recently published deep learning approaches. Conclusion: The CNN-GLCM-SVM fusion framework provides competitive four-class cataract grading without GPU acceleration or specialised cameras, making it suitable for primary-care and telemedicine deployment in resource-limited settings.

Amyotrophic lateral sclerosis (ALS) is a progressive and heterogeneous neurodegenerative disease in which predicting clinically meaningful milestones, such as assistive device use, remains challenging. We developed a time-to-event, digital-twin-inspired framework that integrates longitudinal ALS Functional Rating Scale-Revised (ALSFRS-R) trajectories with survival modeling to support individualized prediction of functional decline and assistive device utilization. We constructed a harmonized longitudinal dataset by integrating diagnosis records, ALSFRS-R assessments, activities of daily living, and demographic information, followed by preprocessing to ensure data quality, temporal alignment, and cohort consistency. Correlation-based clustering identified coherent functional domains spanning bulbar, upper limb, axial, lower limb, and respiratory systems. Generalized additive mixed models characterized nonlinear, domain-specific functional decline across all domains. In addition, a temporal machine learning model was developed to predict longitudinal functional decline and capture stage-dependent disease progression. Cox proportional hazards modeling further identified lower limb function, particularly walking and stair climbing, as the strongest predictors of earlier wheelchair access. Building on these results, we implemented a digital twin-inspired temporal machine learning-based time-to-event (TTE) model that generates individualized survival curves and dynamically predicts wheelchair-free survival. This framework provides a scalable, interpretable, and clinically actionable approach for linking ALS progression with personalized decision support, with applications in proactive care planning, clinical trial stratification, and precision medicine.

Active surveillance (AS) is the preferred strategy for favorable-risk prostate cancer, yet current protocols rely on scheduled repeat biopsies, most of which reveal no progression and are unnecessary. Existing risk-stratification tools operate on single time-point imaging or depend on explicit lesion segmentation, limiting their ability to capture longitudinal change and excluding patients without an MRI-visible lesion. In this study, we propose an end-to-end temporal and multimodal model for predicting pathological progression during AS without lesion segmentation. We encode each serial scan with a pretrained 3D MRI foundation model and introduce a temporal attention gate that recalibrates the multi-visit features to amplify focal imaging changes associated with progression. The gated imaging representation is then fused with clinical variables in a multimodal framework to estimate the probability of progression. Validated on a longitudinal AS cohort, our approach consistently outperforms competing baselines and performs comparably to the radiologist assessment representing current clinical practice. It maintains high negative predictive value while achieving higher positive predictive value, demonstrating its potential to safely reduce unnecessary biopsies during surveillance.

Forecasting the future anatomy of slow-evolving neurodegenerative diseases could enable earlier, more targeted intervention and improve clinical trial design, but it remains challenging because true progression signals are subtle in longitudinal MRI. In this low-signal regime, transferring modern generative sequence models directly is unreliable: training is dominated by stable baseline anatomy and confounded by dense, sample-specific nuisance variation. We first provide a theoretical analysis that explains these failures through two modes. Identity collapse occurs when optimization is driven toward reproducing the current anatomy, which prevents the model from learning faint temporal change. The continuous interpolation trap arises when standard smooth networks cannot separate localized biological drift from pervasive noise, which leads to spurious changes that diffuse across the volume. To address both issues, we propose Latent Drift, a progressive generative framework that learns change in a compressed semantic representation rather than synthesizing full-resolution anatomy. This design removes pixel-level identity from the prediction target and concentrates model capacity on progression-relevant dynamics. We further apply Finite Scalar Quantization to the learned change representation, which suppresses small, high-frequency nuisance fluctuations while preserving consistent structural drift. Experiments on longitudinal 3D brain MRI show that Latent Drift improves patient-specific neuro-forecasting over diffusion and autoregressive transformer baselines across generative fidelity and clinically relevant evaluation metrics. Project page: \href{https://cutepkq.github.io/latent-drift}{https://cutepkq.github.io/latent-drift}.

Engineering Digital Twins and Prognostics and Health Management (PHM) systems rely on robust perception modules to extract actionable information from heterogeneous and non-stationary time-series data. However, most existing approaches remain task-specific, data-hungry, and difficult to integrate into scalable monitoring and decision-making pipelines. Moreover, purely data-driven models often lack robustness and transferability across varying operating conditions. To address these challenges, this paper proposes a modular foundation model for time-series perception based on a collection of pretrained representation encoders. The framework leverages self-supervised learning on heterogeneous datasets to learn transferable and task-agnostic representations, which can be reused across multiple PHM tasks. A gating mechanism is introduced to dynamically select relevant encoders for a given target dataset, enabling conditional computation and adaptive model composition. The selected representations are projected into a shared latent space and aggregated using a Transformer-based self-attention module that explicitly models cross-encoder interactions. The resulting architecture supports multiple downstream tasks, including imputation, long-term forecasting, and few-shot learning, through lightweight task-specific heads, while keeping pretrained encoders frozen during adaptation. Extensive ablation studies demonstrate the complementary roles of self-supervised pretraining, encoder selection, representation alignment, and adaptive aggregation. Experimental results on the ETT benchmark show competitive performance across tasks, while a real-world industrial case study on virtual sensing for hydro-generator rotor temperature highlights the practical relevance of the approach.

Multivariate time-series models for prognostics are often evaluated by point prediction accuracy, yet their internal states rarely expose a coherent degradation process. We study liquid neural networks as latent dynamics models for aircraft engine health monitoring on the C-MAPSS benchmark. The proposed model encodes a history window into a latent state, evolves that state with a liquid transition model, and decodes future sensor observations. To separate health evolution from operating-condition variation, the latent state is factorized into degradation and condition components. Remaining useful life, monotonic risk, and latent-consistency losses supervise the degradation component, while condition prediction and decorrelation losses discourage operating-condition leakage. Across FD001--FD004, the full disentangled model improves overall sensor forecasting RMSE from 0.2438 for a GRU baseline to 0.2266, with the largest gains on the multi-condition subsets FD002 and FD004. The learned degradation state also forms a clearer temporal degradation axis, reaching an average state-speed Spearman correlation of 0.5960. Direct remaining-useful-life regression remains stronger for the GRU baseline, indicating that the proposed representation is currently more effective as an interpretable world model for degradation dynamics than as a calibrated lifetime regressor. These results suggest that liquid latent dynamics can bridge predictive maintenance forecasting and inspectable health-state modeling.

Accurate assessment of tumor proportion score (TPS) in non-small cell lung cancer (NSCLC) is critical for treatment planning and prognosis. Key challenges include the tedious manual work required to annotate each slide, combined with the limited number of experts certified for this task. Multiple instance learning (MIL) has proven to be an effective approach for predicting TPS scores at the slide level; however, existing methods struggle with non-expressive (zero class) images. Our approach involves two models: (1) an embedding-extraction and multiclass-classification network that captures the histopathological features of individual patches, and (2) a MIL model that aggregates these embeddings to predict zero-inflated beta (ZIBeta) parameters representing the overall TPS probability distribution for the entire slide. Using only slide-level TPS scores as labels, we demonstrate how this end-to-end framework can leverage a novel distribution-based architecture to improve prediction accuracy and explainability. ZIBeta modeling significantly outperforms baseline linear and ridge regression while capturing expected accuracy through distribution concentration.

Recent studies have shown that spatial properties of tumors are critical for understanding disease biology and predicting patient outcomes. These spatial properties are increasingly uncovered through complementary modalities: spatial transcriptomics (ST) captures spatially-resolved molecular states, while hematoxylin and eosin-stained whole slide images (HE) reveal tissue morphology. While approaches are emerging to fuse these modalities, effective methods that learn not only joint representations but also incorporate spatial context across modalities are lacking. Here, we present JASPR (Joint Spatial Representation learning), a self-supervised deep learning framework that integrates HE images and ST data through a cross-modal reconstruction objective that incorporates spatial context within HE images and ST profiles. It employs shared modules to capture universal spatial properties across modalities, while modality-specific experts encode features unique to morphological and genomic data. We train and validate JASPR on breast cancer datasets, demonstrating that its learned joint representation substantially improves HE-based prediction of 9,248 genes and provides prognostic value for breast cancer outcomes.

Matched multi-omics can improve WSI-based biomarker and prognosis prediction, but most existing pipelines use omics as a paral lel feature stream or textual context rather than as an explicit retrieval constraint. HERO asks whether observed omics can be a testable mor phology hypothesis: a sparse pathway-to-morphology prior maps DNA methylation and miRNA into a K-dimensional intent vector m (K=16), TF-IDF retrieval over structured 10 captions selects endpoint-relevant regions, and a cosine gate c=cos(m,v) triggers deterministic deficit driven repair when c<τc. This closed-loop design bounds VLM calls, reduces reliance on embedding-based semantic matching, and makes every retrieval and verification step lexically auditable. On TCGA-BRCA (930WSIs, patient-level 5-fold CV), HERO sets new state-of-the-art across ER, PR, HER2, subtype, and risk prediction, outperforming both multimodal fusion and VLM-based baselines.

Predicting time-to-event outcomes such as mortality is a fundamental task in clinical decision-making, commonly addressed through survival analysis. While classical statistical and deep learning approaches have been widely studied, they typically require task-specific training and sufficient labeled data. Recent advances in tabular foundation models offer a new paradigm by learning general-purpose representations for structured data. However, their applicability to censored time-to-event prediction in clinical settings remains underexplored, as typical applications are restricted to discrete classification rather than survival analysis tasks. In this work, we propose a lightweight adaptation approach for applying tabular foundation models to clinical survival analysis by directly training a survival-aware head on top of the pretrained representations. We study representative architectures, including TabPFN, TabDPT, and TabICL, and adapt them using a multi-task logistic regression (MTLR) head to model right-censored time-to-event outcomes. We evaluate this approach on a diverse set of public survival benchmarks and two large-scale ICU cohorts, MIMIC-IV and eICU. Our results show that this transfer learning approach achieves competitive or superior performance compared to strong baselines. On MIMIC-IV, TabDPT-FT-MTLR reaches a C-index of 0.856, corresponding to a relative improvement of +1.4% over the best non-FM baseline (DeepSurv, 0.844) and +6.7% over the best zero-shot model (0.802). On eICU, TabICL-FT-MTLR achieves 0.797, yielding gains of +1.7% (DeepSurv, 0.784) and +6.4% (0.749), respectively. These findings highlight the importance of combining pretrained tabular representations with survival-aware objectives and suggest that tabular foundation models provide a practical and effective alternative for clinical survival prediction.

Routine laboratory panels drawn during cancer treatment constitute longitudinal physiological recordings of organ function, yet their temporal structure is discarded by single-timepoint prognostic tools. A transformer trained on 2,777,595 laboratory measurements from 3,905 patients with multiple myeloma or ovarian cancer predicted the two-year onset of 162 treatment-associated complications, including therapy-related myelodysplastic syndromes, spanning eight clinical categories, achieving 1.5- to 6.1-fold enrichment above prevalence at the group level. It matched or outperformed non-sequential baselines across grouped endpoints (AUROC gains up to +0.11), demonstrating that longitudinal laboratory trajectories capture evolving complication-specific physiology inaccessible from isolated measurements. Predictions generalised across both cancers, divergence concentrating in disease-specific complications, and biomarker masking recovered signatures consistent with established pathophysiology. External validation on MIMIC-IV and MMRF CoMMpass confirmed transferability across independent healthcare systems (AUROC up to 0.85). Routine oncological laboratory data encode organ deterioration weeks to months before clinical onset, enabling complication-specific surveillance without additional testing infrastructure.

Data-driven Prognostics and Health Management (PHM) uses time-varying condition-monitoring data to diagnose system states and estimate remaining useful life in engineered assets. These tasks are central to maintenance planning, but industrial PHM data are often fragmented, partially observed, and poorly labeled, which hinders supervised learning. Foundation models offer a route toward reusable predictive systems, yet most time-series foundation models are designed for forecasting and assume long, coherent, regularly sampled sequences. To address this gap, we propose a framework for applying Tabular Foundation Models to industrial time series using in-context learning, and we evaluate them on a variety of PHM tasks. By converting raw unit-level signals into tabular rows, we show that these models perform well across multiple tasks - including prognostics, and diagnostics - and are highly data efficient. We compare them directly with sequence models, transformer baselines, and gradient-boosted trees under a common evaluation protocol. The results indicate that tabular foundation models achieve the best average ranks across prognostic and diagnostic tasks. Our findings further show that PFN-based models are competitive in low-data regimes, that temporal context can be preserved in the tabular representation, and that performance depends on representative context construction under subsampling. These results demonstrate that tabular foundation models provide a practical and general interface for heterogeneous PHM problems.

Returned products in circular factories re-enter production with heterogeneous degradation states, usage histories, and remaining capability. Reuse cannot be decided from the current inspection alone, because future function fulfillment and component integrity may evolve differently under the next service scenario. Existing PHM approaches support degradation prediction, but often target fixed operating conditions or isolated component benchmarks, while material-fatigue assessment is rarely linked to system-level functional prognosis. This paper addresses this gap for an angle grinder by combining uncertainty-aware functional prediction with component-level fatigue assessment in an instance-specific reliability workflow. The proposed framework combines the current tool state with recent force--torque usage windows. A convolutional encoder extracts loading patterns from spindle forces and shaft torque, and an LSTM backbone predicts nine functional variables as Gaussian mean and variance estimates. In parallel, the same loading history is translated into output-shaft fatigue information through finite-element-supported stress reconstruction, S--N/Miner damage evaluation with Haibach extension, and Paris-law crack-growth analysis. A streaming replay algorithm consolidates both branches into functional, material, and system reliability trajectories. Held-out tests show mean $2\%$-tolerance accuracy of 0.9652 across nine outputs. Thermal variables are predicted near-perfectly, while drive motor current and load speed remain the most demanding dynamic outputs, with $R^2$ values of 0.9750 and 0.9924. Torque history is especially important for these variables, and the conventional LSTM outperforms GRU and xLSTM in the short-history setting. Reliability calibration is most informative for drive motor current, where predicted and observed exceedance probabilities ...

This study presents a novel hybrid prognostic framework for uncertainty-aware Remaining Useful Life (RUL) estimation in turbofan engines using the NASA C-MAPSS dataset. The framework employs a state-aware strategy that bifurcates the engines operational lifespan into "healthy" and "degraded" regimes. An LSTM-based autoencoder, trained strictly on nominal data (RUL > 150 cycles), monitors reconstruction error to act as a robust state classifier. For the healthy regime, a Conditional Weibull Survival Analysis is used for Mean Residual Life estimation. For the degraded regime, a Probabilistic Neural Network with Monte Carlo Dropout captures both aleatoric and epistemic uncertainties. Rather than using rigid binary labels, a calibrated sigmoid function converts the autoencoders output into continuous state probabilities, dynamically weighting the final ensemble prediction. The primary strength of this framework is its generation of physically consistent uncertainty bands, yielding high-confidence predictions near end-of-life while accurately reflecting the inherent variance of early operation, providing a robust tool for risk-informed maintenance.

Effective prognostics and health management of modern engines relies on accurate turbine gas temperature predictions and robust uncertainty quantification to ensure reliability and safety. This paper investigates five major approaches for constructing prediction intervals -- namely the Delta method, Bayesian Monte Carlo Dropout, Bootstrap method, Lower-Upper Bound Estimation, and Mean-Variance Estimation -- as a means of capturing the uncertainty in neural network predictions of turbine gas temperature. Each approach is implemented within a unified experimental framework that employs cross-validation for hyperparameter selection, repeated train-test splits for performance robustness, and multiple metrics to evaluate both the accuracy and tightness of the intervals. In particular, Coverage Probability, Normalized Mean Prediction Interval Width, and the Coverage Width-based Criterion are measured to comprehensively assess each method's reliability and sharpness. Experiments conducted on a representative turbine gas temperature dataset reveal distinct trade-offs among the five methods in terms of interval coverage, width, and stability. These findings provide a practical guide for selecting and tuning prediction interval methods in engine health management and prognostics, ensuring both interpretability and precision in real-world applications.

Industrial Prognostics and Health Management (PHM) provides a representative case study for a broader challenge in applied machine learning: translating published papers into executable, benchmark-ready implementations. Reproducing under-specified methods in PHM is particularly difficult due to restricted access to industrial datasets, incomplete reporting of preprocessing and evaluation protocols, and implicit design choices (e.g., windowing, target construction, data splits) that critically affect performance. Existing paper-to-code systems generate implementations for individual papers, but these artifacts are often not directly comparable due to inconsistencies in assumptions and evaluation settings. We introduce \emph{agentic, framework-based PHM paper reproduction}, where an agent translates a paper into a shared PHM benchmark framework via a \emph{slot-binding interface}. This interface maps equations and protocol descriptions into structured components (task definitions, dataset adapters, windowing, targets, models, and evaluators), while explicitly recording unresolved assumptions. The resulting implementations are validated against standardized task contracts and evaluation hooks, enabling consistent and comparable benchmarking. We evaluate this approach on 16 PHM papers, comparing framework-enhanced, skill-based and prompt-based agentic reproduction against a recent framework-free paper-reproduction agent. We assess reproduction success, model-based code evaluation, framework binding of paper assumptions, and cross-paper benchmark comparability under standardized protocols. Our results show that coupling agentic generation with a shared framework transforms paper reproduction from isolated code synthesis into executable, assumption-aware, and systematically comparable benchmark implementations.

Progress in Prognostics and Health Management (PHM) is hindered by the lack of standardized and reusable evaluation practices across tasks, datasets, and application domains. Reported results are often difficult to reproduce and compare, as key protocol choices, such as data splits, preprocessing, label alignment, temporal windowing, and metrics, are often implicit or implemented ad hoc. We introduce \picid, a modular evaluation infrastructure that formalizes the PHM evaluation pipeline as an explicit, executable, and reproducible protocol. Through well-defined abstractions, \picid enforces deterministic, leakage-safe dataset construction while remaining flexible across diverse PHM settings. The framework supports fault detection, diagnostics, and prognostics through a unified interface and can be extended to new datasets and model classes without violating protocol invariants. By standardizing data contracts and evaluation boundaries, \picid also enables fair cross-task comparisons across diagnostics (classification) and prognostics (regression), allowing identical model families to be evaluated consistently across heterogeneous settings. We demonstrate \picid through an empirical evaluation of thirteen models on twelve datasets spanning batteries, bearings, turbofan engines, hydraulics, filtration systems, and buildings. This work establishes a reusable foundation for standardized, fair and reproducible evaluation in PHM.

Early-warning models built from Learning Management System (LMS) logs aim to predict end-of-course outcomes early enough to enable timely learner support. However, reported "early" performance is often inflated by temporal leakage. This occurs when the pipeline uses information that would not yet be available at the time of prediction. We formalize cutoff-based early outcome prediction under a temporal availability constraint and introduce LEAP (Leakage-Excluded Early-Availability Protocol), which enforces cutoff-first truncation prior to joins and aggregation and audits feature provenance to prevent post-cutoff evidence from entering the benchmark. We instantiate LEAP on the public Open University Learning Analytics Dataset (OULAD) as a multi-step protocol for leakage-controlled evaluation across weekly cutoffs. Using several standard learning methods, we evaluate performance using ROC-AUC, PR-AUC, Brier score, and F1@0.5. Results show improving performance as the observation window expands, with a marked gain around week~3; Random Forest performs best at the earliest cutoffs, while Gradient Boosting dominates thereafter. Leakage ablations further show that temporal violations, especially through assessment information, can inflate apparent "early" performance.

Hospital readmission within 30 days of discharge is a leading driver of morbidity, mortality, and avoidable healthcare expenditure in congestive heart failure (CHF). Current clinical risk stratification tools rely primarily on non-imaging data and exhibit limited predictive performance. Point-of-care lung ultrasound (LUS) offers a sensitive, noninvasive window into the pulmonary congestion that characterizes CHF decompensation, yet its prognostic utility for readmission prediction remains largely unexplored. We present a pilot feasibility study, the first systematic machine learning study using B-mode LUS acquired during hospitalization to predict 30-day CHF readmission. Quantitative spatiotemporal embeddings are extracted from a pretrained Temporal Shift Module (TSM) ResNet-18 encoder, and interpretable biomarker features are separately evaluated. Through structured ablations over lung view, temporal representation, multi-view fusion, and cross-lung augmentation, we identify the key imaging factors driving readmission risk. Our findings reveal that (1) dependent lower-lung regions (Left-3, Right-3) carry the strongest prognostic signal, consistent with their greater susceptibility to hydrostatic congestion; (2) temporal difference features between sequential examinations substantially outperform single-timepoint representations, highlighting the importance of capturing disease trajectory; and (3) multi-view feature concatenation yields the best overall performance, with our top MLP model achieving an F1 score of 0.80 (95% CI: 0.62-0.96). Biomarker analysis further reveals that pleural-line abnormalities, including breaks and indentations, are as informative as the canonical A-line and B-line markers. These results support POCUS-derived biomarkers as practical, interpretable tools for noninvasive CHF risk stratification.

Myocardial infarction (MI) is a leading cause of death, and its adverse outcomes are urgent to predict. Yet ECG-based prognostic models underperform because deep learning requires large, labelled datasets, which are scarce in medicine. Foundation models can learn from unlabelled ECGs via selfsupervision, but medically relevant training strategies remain underexplored. We propose a pretrained artificial intelligence model that combines patient-specific temporal information using contrastive learning with supervised multitask heads, then fine-tunes on post-MI outcome prediction. The proposed model outperformed a model trained from scratch (0.794 vs 0.608 AUC) showing that clinically structured ECG modelling improves classification in limited data regimes.

This work studies lung tumor growth prediction from sparse and irregular longitudinal computed tomography (CT) observations with measurement variability. A Bayesian physics-informed neural network is developed by combining Gompertz growth dynamics with low-dimensional Bayesian inference in the log-volume domain. The framework employs a two-stage inference strategy combining maximum a posteriori (MAP) estimation and Hamiltonian Monte Carlo (HMC) sampling to estimate posterior predictive distributions and uncertainty intervals. The method was evaluated on longitudinal data from the National Lung Screening Trial (30 patients). Results show that the model captures heterogeneous tumor growth patterns while maintaining reasonable prediction accuracy under limited observations. Compared with deterministic modeling approaches, the proposed approach additionally provides calibrated uncertainty estimates. The inferred posterior parameter correlations were consistent with expected biological growth behavior. The proposed framework achieved a cohort-level log-space RMSE of approximately 0.20 together with well-calibrated 95% credible interval coverage across 30 patients. These findings suggest that Bayesian physics-informed modeling may be useful for uncertainty-aware tumor growth assessment when only limited longitudinal follow-up scans are available.

Randomized controlled trials typically assume that prognostic covariates are known and available at no cost. In practice, obtaining high-dimensional pretreatment data is costly, forcing a trade-off between covariate-adaptive precision and a measurement budget. We introduce Dynamic Adaptive Rerandomization via Thompson Sampling (DARTS), which treats covariate acquisition as a sequential optimization problem embedded within a design-based causal inference task. A budgeted combinatorial Thompson sampler learns which covariates are most prognostic across successive batches; selected covariates then drive rerandomization and regression adjustment to reduce batch-level average treatment effect variance. Our primary theoretical contribution is a decoupling result: adaptive covariate selection based on past batches preserves batch-level randomization validity, and the cumulative inverse-variance weighted estimator achieves at least nominal asymptotic coverage. We further derive a Bayes risk bound for the acquisition layer that matches the minimax lower bound up to logarithmic factors. Empirically, DARTS systematically concentrates the budget on informative features, significantly closing the efficiency gap to oracle designs while maintaining strict inferential validity.

In recent years, machine learning has made significant progress in clinical outcome prediction, demonstrating increasingly accurate results. However, the substantial resources required for hospitals to train these models, such as data collection, labeling, and computational power, limit the feasibility for smaller hospitals to develop their own models. An alternative approach involves transferring a machine learning model trained by a large hospital to smaller hospitals, allowing them to fine-tune the model on their specific patient data. However, these models are often trained and validated on data from a single hospital, raising concerns about their generalizability to new data. Our research shows that there are notable differences in measurement distributions and frequencies across various regions in the United States. To address this, we propose a benchmark that tests a machine learning model's ability to transfer from a source domain to different regions across the country. This benchmark assesses a model's capacity to learn meaningful information about each new domain while retaining key features from the original domain. Using this benchmark, we frame the transfer of a machine learning model from one region to another as a domain incremental learning problem. While the task of patient outcome prediction remains the same, the input data distribution varies, necessitating a model that can effectively manage these shifts. We evaluate two popular domain incremental learning methods: data replay, which stores examples from previous data sources for fine-tuning on the current source, and Elastic Weight Consolidation (EWC), a model parameter regularization method that maintains features important for both data sources.

Artificial intelligence (AI) is becoming a clinical tool for prostate pathology, but generalization across variations in sample preparation and preservation over prolonged time periods remains poorly understood. We evaluated GleasonAI, an end-to-end attention-based multiple instance learning model, on an independent validation cohort comprising 10,366 biopsy cores from 1,028 patients across 14 Swedish regions, using archival diagnostic specimens from the ProMort cohorts collected between 1998-2015. The model achieved an overall quadratic-weighted kappa of 0.86 for core-level ISUP grading, comparable to several experienced pathologists and consistent across geographic regions. Notably, performance remained stable across the 17-year collection period, demonstrating robustness to time-related variation in archival material, a property not consistently observed with foundation model-based approaches, with exploratory analysis demonstrating a significant prognostic gradient across AI-assigned grade groups for prostate cancer-specific mortality. These findings support the generalizability of the AI grading model and demonstrate the potential of pathology archives as a large-scale resource for AI development, validation, and retrospective prognostic research.

Accurate prediction of Remaining Useful Life (RUL) in aero-engines is vital for predictive maintenance, improved operational reliability, and reduced lifecycle costs. While deep learning approaches have demonstrated strong potential in this area, most existing methods focus primarily on model architecture design and treat input features uniformly, often neglecting the influence of data preprocessing. In this work, we propose a novel preprocessing pipeline that enhances RUL prediction by improving data quality and temporal representation before model training. Our approach leverages complete temporal sequences and generates RUL estimates at each timestep, enabling the model to capture fine-grained degradation dynamics and deliver continuous prognostic insights throughout the engine's operational life. To validate the effectiveness of the proposed pipeline, we conduct experiments on the NASA C-MAPSS dataset. Comparative evaluations against a suite of state-of-the-art neural models including CNN, RNN, LSTM, DCNN, TCN, BiGRU-TSAM, AGCNN, and ATCN, demonstrate that our approach consistently achieves superior accuracy and robustness in aero-engine RUL prediction. These results highlight the critical role of preprocessing in maximizing the effectiveness of neural prognostic models.

Remaining Useful Life (RUL) estimation is a critical component of Prognostics and Health Management (PHM), enabling proactive maintenance scheduling and reducing unplanned failures in industrial equipment. This paper presents a comparative study of machine learning approaches for RUL estimation on the NASA C-MAPSS turbofan engine dataset: classical baselines (Ridge Regression, Polynomial Ridge, and XGBoost), a 1D Convolutional Neural Network (CNN), and a Long Short-Term Memory (LSTM) network. All models are evaluated on the FD001 and FD003 subsets under an identical preprocessing pipeline to ensure a fair comparison. Among raw-sequence models, the LSTM achieves RMSE of 14.93 and 14.20 on FD001 and FD003 respectively, outperforming the deep LSTM reported by Zheng et al.~\cite{paper} (RMSE 16.14 and 16.18) despite using a simpler single-layer architecture. The 1D CNN achieves RMSE of 16.97 on FD001 and 15.68 on FD003, demonstrating competitive performance on FD003 while producing more conservative RUL predictions on FD001. Ridge Regression is evaluated on raw and engineered features, while other classical models use only engineered inputs. XGBoost achieves an RMSE of 13.36 on FD003, highlighting the competitiveness of nonlinear modeling.

Skull-base meningiomas are often characterized by favorable long-term prognosis, yet their anatomical complexity and proximity to critical neurovascular structures make treatment selection challenging. Stereotactic radiosurgery with CyberKnife represents an effective therapeutic option when surgical resection is not feasible; however, not all patients benefit equally from this treatment. Early identification of patients likely to respond to radiosurgery remains an open clinical problem. In this study, we propose a radiomics- and clinical feature-driven framework for predicting volumetric response in skull-base meningiomas treated with CyberKnife. Unlike most existing approaches that focus on progression-free survival or recurrence, our method targets volumetric response as an indicator of treatment efficacy. Pre-treatment MRI images from 104 patients were processed to extract radiomic features, which were combined with clinical variables and analyzed using six models. To ensure methodological rigor, the entire modeling process was implemented within a nested cross-validation scheme. Among the evaluated models, TabPFN achieved the best overall performance, with an AUC of 0.81 and consistently favorable classification metrics. These results suggest that advanced machine learning architectures, when combined with robust validation strategies, can effectively capture patterns associated with treatment response even in small-sample, high-dimensional settings.

Chronic osteomyelitis presents substantial prognostic challenges due to its high recurrence risk and complex postoperative recovery trajectories. Traditional assessment often relies on manual scoring systems, which limit scalability, efficiency, and consistency in clinical practice. Furthermore, the heterogeneous nature of clinical data poses challenges for current multimodal learning approaches that require aligned inputs and large annotated datasets. In this work, we propose RAG4Outcome, a retrieval-augmented generation (RAG) framework for prognostic prediction in chronic osteomyelitis. Our method integrates multimodal clinical data, including PET-CT imaging reports, structured surgical and diagnostic records, and unstructured follow-up notes, into a unified prediction pipeline. By combining a domain-specific retrieval corpus with expert-guided prompting, the framework enables more interpretable, evidence-grounded, and clinically reliable prognosis. Preliminary results on real-world cases demonstrate promising effectiveness and clinical alignment, highlighting the potential of RAG4Outcome for AI-assisted infection management and postoperative decision support.

Multimodal clinical records contain structured measurements and clinical notes recorded over time, offering rich temporal information about the evolution of patient health. Yet these observations are sparse, and whether they are recorded depends on the patient's latent condition. Observation patterns also differ across modalities, as structured measurements and clinical notes arise under distinct recording processes. While prior work has developed methods that accommodate missingness in clinical time series, how to extract and use the information carried by the observation process itself remains underexplored. We therefore propose a patient representation learning framework for multimodal clinical time series that explicitly leverages informative missingness. The framework combines (1) a multimodal encoder that captures signals from structured and textual data together with their observation patterns, (2) a Bayesian filtering module that updates a latent patient state over time from observed multimodal signals, and (3) downstream modules for offline treatment policy learning and patient outcome prediction based on the learned patient state. We evaluate the framework on ICU sepsis cohorts from MIMIC-III, MIMIC-IV, and eICU. It improves both offline treatment policy learning and adverse outcome prediction, achieving FQE 0.679 versus 0.528 for clinician behavior and AUROC 0.886 for post-72-hour mortality prediction on MIMIC-III.

For head and neck cancer (HNC) patients, prognostic outcome prediction can support personalized treatment strategy selection. Improving prediction performance of HNC outcomes has been extensively explored by using advanced artificial intelligence (AI) techniques on PET/CT data. However, the interpretability of AI remains a critical obstacle for its clinical adoption. Unlike previous HNC studies that empirically selected explainable AI (XAI) techniques, we are the first to comprehensively evaluate and rank 13 XAI methods across 24 metrics, covering faithfulness, robustness, complexity and plausibility. Experimental results on the multi-center HECKTOR challenge dataset show large variations across evaluation aspects among different XAI methods, with Integrated Gradients (IG) and DeepLIFT (DL) consistently obtained high rankings for faithfulness, complexity and plausibility. This work highlights the importance of comprehensive XAI method evaluation and can be extended to other medical imaging tasks.

External validation is widely regarded as the gold standard for prognostic model evaluation. In this study, we challenge the assumption that successful external calibration guarantees model generalizability and propose two complementary strategies to improve transportability of prognostic models across cohorts. Using six real-world surgical cohorts from tertiary academic centers, we tested whether successful external calibration depends largely on similarity in covariates and outcomes between training and validation cohorts, quantified using Kullback-Leibler (KL) divergence, with calibration assessed by the Integrated Calibration Index (ICI). From the model-developer's perspective, we trained the "best-on-average" prognostic model by tuning toward a meta-analysis-derived covariate and outcome distribution as an approximation of the broader target population. From the end-user perspective, we proposed a simple measure for cohort outcome similarity to identify, among published models, the one most suitable for a given target cohort in terms of both calibration and clinical utility. External calibration worsened as distributional mismatch increased. Higher KL divergence was associated with higher ICI in both surgery-alone (Spearman $ρ=0.614$, $p=0.004$) and surgery + adjuvant chemotherapy cohorts (Spearman $ρ=0.738$, $p<0.001$). Meta-analysis-informed weighting improved calibration in most settings without materially affecting discrimination, with the clearest benefit when evaluated on the aggregated external population ($p=0.037$). Models developed in more similar cohorts achieved lower ICI in surgery-alone (Spearman $ρ=0.803$, $p<0.001$) and surgery + adjuvant chemotherapy cohorts (Spearman $ρ=0.737$, $p<0.001$), and provided greater clinical utility on DCA.

Physics-Informed Neural Networks (PINNs) provide a framework for integrating physical laws with data. However, their application to Prognostics and Health Management (PHM) remains constrained by the limited uncertainty quantification (UQ) capabilities. Most existing PINN-based prognostics approaches are deterministic or account only for epistemic uncertainty, limiting their suitability for risk-aware decision-making. This work introduces a heteroscedastic Bayesian Physics-Informed Neural Network (B-PINN) framework that jointly models epistemic and aleatoric uncertainty, yielding full predictive posteriors for spatiotemporal insulation material ageing estimation. The approach integrates Bayesian Neural Networks (BNNs) with physics-based residual enforcement and prior distributions, enabling probabilistic inference within a physics-informed learning architecture. The framework is evaluated on transformer insulation ageing application, validated with a finite-element thermal model and field measurements from a solar power plant, and benchmarked against deterministic PINNs, dropout-based PINNs (d-PINNs), and alternative B-PINN variants. Results show that the proposed B-PINN provides improved predictive accuracy and better-calibrated uncertainty estimates than competing approaches. A systematic sensitivity study further analyzes the impact of boundary-condition, initial-condition, and residual sampling strategies on accuracy, calibration, and generalization, and the influence of measurement noise on aleatoric uncertainty. Overall, the findings highlight the capability of Bayesian physics-informed learning to support uncertainty-aware prognostics and informed decision-making in transformer asset management by tracking aleatoric and epistemic sources of uncertainty.

Chronic Kidney Disease (CKD) affects nearly 10% of the global population and often progresses to end-stage renal failure. Accurate prognosis prediction is vital for timely interventions and resource optimization. We present a transformer-based framework for predicting CKD progression using multi-modal electronic health records (EHR) from the Seoul National University Hospital OMOP Common Data Model. Our approach (\textbf{ProQ-BERT}) integrates demographic, clinical, and laboratory data, employing quantization-based tokenization for continuous lab values and attention mechanisms for interpretability. The model was pretrained with masked language modeling and fine-tuned for binary classification tasks predicting progression from stage 3a to stage 5 across varying follow-up and assessment periods. Evaluated on a cohort of 91,816 patients, our model consistently outperformed CEHR-BERT, achieving ROC-AUC up to 0.995 and PR-AUC up to 0.989 for short-term prediction. These results highlight the effectiveness of transformer architectures and temporal design choices in clinical prognosis modeling, offering a promising direction for personalized CKD care.

Machine learning approaches for image classification have led to impressive advances in that field. For example, convolutional neural networks are able to achieve remarkable image classification accuracy across a wide range of applications in industry, defense, and other areas. While these machine learning models boast impressive accuracy, a related concern is how to assess and maintain calibration in the predictions these models make. A classification model is said to be well calibrated if its predicted probabilities correspond with the rates events actually occur. While there are many available methods to assess machine learning calibration and recalibrate faulty predictions, less effort has been spent on developing approaches that continually monitor predictive models for potential loss of calibration as time passes. We propose a cumulative sum-based approach with dynamic limits that enable detection of miscalibration in both traditional process monitoring and concept drift applications. This enables early detection of operational context changes that impact image classification performance in the field. The proposed chart can be used broadly in any situation where the user needs to monitor probability predictions over time for potential lapses in calibration. Importantly, our method operates on probability predictions and event outcomes and does not require under-the-hood access to the machine learning model.