Emerging from NASA's spacecraft simulations in the 1960s, digital twin technology has advanced through industrial adoption to spark a healthcare transformation. A digital twin is a dynamic, data-driven virtual counterpart of a physical system, continuously updated through real-time data streams and capable of bidirectional interaction. In medicine, digital twin integrates imaging, biosensors, and computational models to generate patient-specific simulations that support diagnosis, treatment planning, and drug development. Representative applications include cardiac digital twin for predicting arrhythmia treatment outcomes, oncology digital twin for tracking tumor progression and optimizing radiotherapy, and pharmacological digital twin for accelerating drug discovery. Despite rapid progress, major challenges, including interoperability, data privacy, and model fidelity, continue to limit widespread clinical integration. Emerging solutions such as explainable AI, federated learning, and harmonized regulatory frameworks offer promising pathways forward. Looking ahead, advances in multi-organ digital twin, genomics integration, and ethical governance will be essential to ensure that digital twin shifts healthcare from reactive treatment to predictive, preventive, and truly personalized medicine.

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 substantial diversity within these dimensions, reflecting the breadth and evolution of NLP research in cardiology. A temporal analysis further highlights methodological trends, showing a progression from rule-based systems to large language models. Finally, we discuss key challenges and future directions, such as developing interpretable LLMs and integrating multimodal data. To the best of our knowledge, this review represents the most comprehensive synthesis of NLP research in cardiology to date.

Artificial intelligence (AI) has become increasingly central to precision medicine by enabling the integration and interpretation of multimodal data, yet implementation in clinical settings remains limited. This paper provides a scoping review of literature from 2019-2024 on the implementation of AI in precision medicine, identifying key barriers and enablers across data quality, clinical reliability, workflow integration, and governance. Through an ecosystem-based framework, we highlight the interdependent relationships shaping real-world translation and propose future directions to support trustworthy and sustainable implementation. Traditional healthcare models have difficulty addressing the complexity of modern healthcare needs, particularly given the increasingly multimodal nature of health data spanning genetic, clinical, behavioral, environmental, and lifestyle information (Topol, 2023; Judge et al., 2024; Schouten et al., 2025). As precision medicine emerges as a promising solution for integrating multimodal data into healthcare, a new implementation strategy is necessary due to the complexity of existing healthcare structures and the extent of interdisciplinary collaboration that is now required (Tobias et al., 2023).

The automated analysis of phonocardiograms is vital for the early diagnosis of cardiovascular disease, yet supervised deep learning is often constrained by the scarcity of expert-annotated data. In this paper, we propose the Self-Supervised Dual-Path Prototypical Network (SS-DPPN), a foundation model for cardiac audio representation and classification from unlabeled data. The framework introduces a dual-path contrastive learning based architecture that simultaneously processes 1D waveforms and 2D spectrograms using a novel hybrid loss. For the downstream task, a metric-learning approach using a Prototypical Network was used that enhances sensitivity and produces well-calibrated and trustworthy predictions. SS-DPPN achieves state-of-the-art performance on four cardiac audio benchmarks. The framework demonstrates exceptional data efficiency with a fully supervised model on three-fold reduction in labeled data. Finally, the learned representations generalize successfully across lung sound classification and heart rate estimation. Our experiments and findings validate SS-DPPN as a robust, reliable, and scalable foundation model for physiological signals.

Objective: Chagas disease is a parasitic infection that is endemic to South America, Central America, and, more recently, the U.S., primarily transmitted by insects. Chronic Chagas disease can cause cardiovascular diseases and digestive problems. Serological testing capacities for Chagas disease are limited, but Chagas cardiomyopathy often manifests in ECGs, providing an opportunity to prioritize patients for testing and treatment. Approach: The George B. Moody PhysioNet Challenge 2025 invites teams to develop algorithmic approaches for identifying Chagas disease from electrocardiograms (ECGs). Main results: This Challenge provides multiple innovations. First, we leveraged several datasets with labels from patient reports and serological testing, provided a large dataset with weak labels and smaller datasets with strong labels. Second, we augmented the data to support model robustness and generalizability to unseen data sources. Third, we applied an evaluation metric that captured the local serological testing capacity for Chagas disease to frame the machine learning problem as a triage task. Significance: Over 630 participants from 111 teams submitted over 1300 entries during the Challenge, representing diverse approaches from academia and industry worldwide.

Artificial intelligence (AI) has demonstrated significant potential in ECG analysis and cardiovascular disease assessment. Recently, foundation models have played a remarkable role in advancing medical AI. The development of an ECG foundation model holds the promise of elevating AI-ECG research to new heights. However, building such a model faces several challenges, including insufficient database sample sizes and inadequate generalization across multiple domains. Additionally, there is a notable performance gap between single-lead and multi-lead ECG analyses. We introduced an ECG Foundation Model (ECGFounder), a general-purpose model that leverages real-world ECG annotations from cardiology experts to broaden the diagnostic capabilities of ECG analysis. ECGFounder was trained on over 10 million ECGs with 150 label categories from the Harvard-Emory ECG Database, enabling comprehensive cardiovascular disease diagnosis through ECG analysis. The model is designed to be both an effective out-of-the-box solution, and a to be fine-tunable for downstream tasks, maximizing usability. Importantly, we extended its application to lower rank ECGs, and arbitrary single-lead ECGs in particular. ECGFounder is applicable to supporting various downstream tasks in mobile monitoring scenarios. Experimental results demonstrate that ECGFounder achieves expert-level performance on internal validation sets, with AUROC exceeding 0.95 for eighty diagnoses. It also shows strong classification performance and generalization across various diagnoses on external validation sets. When fine-tuned, ECGFounder outperforms baseline models in demographic analysis, clinical event detection, and cross-modality cardiac rhythm diagnosis. The trained model and data will be publicly released upon publication through the bdsp.io. Our code is available at https://github.com/bdsp-core/ECGFounder

This article investigates how translation memories (TM) can be created by translators or other language professionals in order to compile domain-specific parallel corpora , which can then be used in different scenarios, such as machine translation training and fine-tuning, TM leveraging, and/or large language model fine-tuning. The article introduces a semi-automatic TM preparation methodology leveraging primarily translation tools used by translators in favor of data quality and control by the translators. This semi-automatic methodology is then used to build a cardiology-based Turkish -> English corpus from bilingual abstracts of Turkish cardiology journals. The resulting corpus called TRENCARD Corpus has approximately 800,000 source words and 50,000 sentences. Using this methodology, translators can build their custom TMs in a reasonable time and use them in their bilingual data requiring tasks.

The ethical integration of Artificial Intelligence (AI) in healthcare necessitates addressing fairness--a concept that is highly context-specific across medical fields. Extensive studies have been conducted to expand the technical components of AI fairness, while tremendous calls for AI fairness have been raised from healthcare. Despite this, a significant disconnect persists between technical advancements and their practical clinical applications, resulting in a lack of contextualized discussion of AI fairness in clinical settings. Through a detailed evidence gap analysis, our review systematically pinpoints several deficiencies concerning both healthcare data and the provided AI fairness solutions. We highlight the scarcity of research on AI fairness in many medical domains where AI technology is increasingly utilized. Additionally, our analysis highlights a substantial reliance on group fairness, aiming to ensure equality among demographic groups from a macro healthcare system perspective; in contrast, individual fairness, focusing on equity at a more granular level, is frequently overlooked. To bridge these gaps, our review advances actionable strategies for both the healthcare and AI research communities. Beyond applying existing AI fairness methods in healthcare, we further emphasize the importance of involving healthcare professionals to refine AI fairness concepts and methods to ensure contextually relevant and ethically sound AI applications in healthcare.

Heart failure (HF) poses a significant public health challenge, with a rising global mortality rate. Early detection and prevention of HF could significantly reduce its impact. We introduce a novel methodology for predicting HF risk using 12-lead electrocardiograms (ECGs). We present a novel, lightweight dual-attention ECG network designed to capture complex ECG features essential for early HF risk prediction, despite the notable imbalance between low and high-risk groups. This network incorporates a cross-lead attention module and twelve lead-specific temporal attention modules, focusing on cross-lead interactions and each lead's local dynamics. To further alleviate model overfitting, we leverage a large language model (LLM) with a public ECG-Report dataset for pretraining on an ECG-report alignment task. The network is then fine-tuned for HF risk prediction using two specific cohorts from the UK Biobank study, focusing on patients with hypertension (UKB-HYP) and those who have had a myocardial infarction (UKB-MI).The results reveal that LLM-informed pre-training substantially enhances HF risk prediction in these cohorts. The dual-attention design not only improves interpretability but also predictive accuracy, outperforming existing competitive methods with C-index scores of 0.6349 for UKB-HYP and 0.5805 for UKB-MI. This demonstrates our method's potential in advancing HF risk assessment with clinical complex ECG data.

This study proposes the use of Machine Learning models to predict the early onset of sepsis using deidentified clinical data from Montefiore Medical Center in Bronx, NY, USA. A supervised learning approach was adopted, wherein an XGBoost model was trained utilizing 80\% of the train dataset, encompassing 107 features (including the original and derived features). Subsequently, the model was evaluated on the remaining 20\% of the test data. The model was validated on prospective data that was entirely unseen during the training phase. To assess the model's performance at the individual patient level and timeliness of the prediction, a normalized utility score was employed, a widely recognized scoring methodology for sepsis detection, as outlined in the PhysioNet Sepsis Challenge paper. Metrics such as F1 Score, Sensitivity, Specificity, and Flag Rate were also devised. The model achieved a normalized utility score of 0.494 on test data and 0.378 on prospective data at threshold 0.3. The F1 scores were 80.8\% and 67.1\% respectively for the test data and the prospective data for the same threshold, highlighting its potential to be integrated into clinical decision-making processes effectively. These results bear testament to the model's robust predictive capabilities and its potential to substantially impact clinical decision-making processes.